The Experts below are selected from a list of 6765 Experts worldwide ranked by ideXlab platform

Thomas H Marwick - One of the best experts on this subject based on the ideXlab platform.

  • incremental value of Strain Rate Imaging to wall motion analysis for prediction of outcome in patients undergoing dobutamine stress echocardiography
    Circulation, 2007
    Co-Authors: Charlotte Bjork Ingul, Stig A Slordahl, Ellen Rozis, Thomas H Marwick
    Abstract:

    Background— Wall motion score at dobutamine stress echocardiography is an independent predictor of mortality. We sought to determine whether quantification of DSE by Strain Rate Imaging was incremental to wall motion score for predicting outcome. Methods and Results— In 646 patients undergoing dobutamine stress echocardiography for the evaluation of known or suspected coronary disease, customized software was used to automatically measure peak systolic Strain Rate (SRs) and end-systolic Strain (Ses) in 18 segments. Results were expressed as the number of abnormal segments and the mean SRs and Ses per patient. All-cause mortality was identified over 7 years of follow-up (mean, 5.2±1.5 years). Contributions of clinical, wall motion, and SRs and Ses data to outcome were analyzed with Cox models, which also were used to define cut points for SRs and Ses. Ischemia (new or worsening wall motion abnormalities) was detected in 45%, and 39% had a previous myocardial infarction. In patients with no ischemia, annual...

  • incremental value of Strain Rate Imaging to wall motion analysis for prediction of outcome in patients undergoing dobutamine stress echocardiography
    Circulation, 2007
    Co-Authors: Charlotte Bjork Ingul, Stig A Slordahl, Ellen Rozis, Thomas H Marwick
    Abstract:

    BACKGROUND: Wall motion score at dobutamine stress echocardiography is an independent predictor of mortality. We sought to determine whether quantification of DSE by Strain Rate Imaging was incremental to wall motion score for predicting outcome. METHODS AND RESULTS: In 646 patients undergoing dobutamine stress echocardiography for the evaluation of known or suspected coronary disease, customized software was used to automatically measure peak systolic Strain Rate (SR(s)) and end-systolic Strain (S(es)) in 18 segments. Results were expressed as the number of abnormal segments and the mean SR(s) and S(es) per patient. All-cause mortality was identified over 7 years of follow-up (mean, 5.2+/-1.5 years). Contributions of clinical, wall motion, and SR(s) and S(es) data to outcome were analyzed with Cox models, which also were used to define cut points for SR(s) and S(es). Ischemia (new or worsening wall motion abnormalities) was detected in 45%, and 39% had a previous myocardial infarction. In patients with no ischemia, annualized mortality without and with previous myocardial infarction were 2% and 3% compared with 5% in patients with ischemia. Peak wall motion score index, mean SR(s), segmental S(es), and segmental SR(s) were all predictors of mortality, but only segmental SR(s) (hazard ratio, 3.6; 95% CI, 1.7 to 7.2) was independently predictive. In sequential Cox models, the model based on clinical data (overall chi2, 12.7) was improved by peak wall motion score index (18.4, P=0.002) and further increased by either segmental SR(s) (31.8, P<0.001) or mean SR(s) (25.7, P=0.009). CONCLUSIONS: Segmental analysis by SR(s), derived from automated Strain Rate Imaging analysis of dobutamine stress echocardiography response, offers prognostic information that is independent and incremental to standard wall motion score index.

  • differentiation of subendocardial and transmural infarction using two dimensional Strain Rate Imaging to assess short axis and long axis myocardial function
    Journal of the American College of Cardiology, 2006
    Co-Authors: Jonathan Chan, L Hanekom, Chiew Wong, Rodel Leano, Gooyeong Cho, Thomas H Marwick
    Abstract:

    Objectives This study sought to differentiate the transmural extent of infarction (TME) by assessment of the short-axis and long-axis function of the left ventricle (LV) using 2-dimensional (2D) Strain. Background The differentiation of subendocardial infarction from transmural infarction has significant prognostic and clinical implications. Methods Contrast-enhanced magnetic resonance Imaging (CE-MRI) and dobutamine stress echocardiography (DBE) were performed in 80 patients (age 63 ± 10 years) with chronic ischemic LV dysfunction. Myocardial function was assessed in the short axis at the midventricular level using peak Strain Rate (SR) and Strain (S) in circumferential and radial dimensions, and was assessed in the long axis using longitudinal SR and S. Wall motion analysis was performed during DBE to assess for contractile reserve. Results Transmural infarct segments had lower circumferential S (−10.7 ± 6.3) and SR (−1.0 ± 0.4) than subendocardial infarcts (S: −15.4 ± 7.0, p Conclusions The combined assessment of long-axis and short-axis function using 2D Strain may be used to identify TME.

  • relationship between myocardial perfusion and dysfunction in diabetic cardiomyopathy a study of quantitative contrast echocardiography and Strain Rate Imaging
    Heart, 2006
    Co-Authors: S Moir, L Hanekom, Zhi You Fang, Brian Haluska, Chiew Wong, Malcolm I Burgess, Thomas H Marwick
    Abstract:

    Objective: To use quantitative myocardial contrast echocardiography (MCE) and Strain Rate Imaging (SRI) to assess the role of microvascular disease in subclinical diabetic cardiomyopathy. Methods: Stress MCE and SRI were performed in 48 patients (22 with type II diabetes mellitus (DM) and 26 controls), all with normal left ventricular systolic function and no obstructive coronary disease by quantitative coronary angiography. Real-time MCE was acquired in three apical views at rest and after combined dipyridamole–exercise stress. Myocardial blood flow (MBF) was quantified in the 10 mid- and apical cardiac segments at rest and after stress. Resting peak systolic Strain Rate (SR) and peak systolic Strain (e) were calculated in the same 10 myocardial segments. Results: The DM and control groups were matched for age, sex and other risk factors, including hypertension. The DM group had higher body mass index and left ventricular mass index. Quantitative SRI analysis was possible in all patients and quantitative MCE in 46 (96%). The mean e, SR and MBF reserve were all significantly lower in the DM group than in controls, with diabetes the only independent predictor of each parameter. No correlation was seen between MBF and SR (r  =  −0.01, p  =  0.54) or between MBF and e (r  =  −0.20, p  =  0.20). Conclusions: Quantitative MCE shows that patients with diabetes but no evidence of obstructive coronary artery disease have impaired MBF reserve, but abnormal transmural flow and subclinical longitudinal myocardial dysfunction are not related.

  • incremental value of Strain Rate analysis as an adjunct to wall motion scoring for assessment of myocardial viability by dobutamine echocardiography a follow up study after revascularization
    Circulation, 2005
    Co-Authors: L Hanekom, Carly Jenkins, Leanne Jeffries, Colin Case, Julie Mundy, Carmel M Hawley, Thomas H Marwick
    Abstract:

    Background— Assessment of myocardial viability based on wall-motion scoring (WMS) during dobutamine echocardiography (DbE) is difficult and subjective. Strain-Rate Imaging (SRI) is quantitative, but its incremental value over WMS for prediction of functional recovery after revascularization is unclear. Methods and Results— DbE and SRI were performed in 55 stable patients (mean age, 64±10 years; mean ejection fraction, 36±8%) with previous myocardial infarction. Viability was predicted by WMS if function augmented during low-dose DbE. SR, end-systolic Strain (ESS), postsystolic Strain (PSS), and timing parameters were analyzed at rest and with low-dose DbE in abnormal segments. Regional and global functional recovery was defined by side-by-side comparison of echocardiographic images before and 9 months after revascularization. Of 369 segments with abnormal resting function, 146 showed regional recovery. Compared with segments showing functional recovery, those that failed to recover had lower low-dose DbE ...

Jan Dhooge - One of the best experts on this subject based on the ideXlab platform.

  • principal component analysis for the classification of cardiac motion abnormalities based on echocardiographic Strain and Strain Rate Imaging
    International Conference on Functional Imaging and Modeling of Heart, 2015
    Co-Authors: Mahdi Tabassian, Martino Alessandrini, Luca De Marchi, G Masetti, Nicholas Cauwenberghs, Tatiana Kouznetsova, Jan Dhooge
    Abstract:

    Clinical value of the quantitative assessment of regional myocardial function through segmental Strain and Strain Rate has already been demonstRated. Traditional methods for diagnosing heart diseases are based on values extracted at specific time points during the cardiac cycle, known as ‘techno-markers’, and as a consequence they may fail to provide an appropriate description of the Strain (Rate) characteristics. This study concerns the statistical analysis of the whole cardiac cycle by the Principal Component Analysis (PCA) method and modeling the major patterns of the Strain (Rate) curves. Experimental outcomes show that the PCA features can outperform their traditional counterparts in categorizing healthy and infarcted myocardial segments and are able to drive considerable benefit to a classification system by properly modeling the complex structure of the Strain Rate traces.

  • exercise Strain Rate Imaging demonstRates normal right ventricular contractile reserve and clarifies ambiguous resting measures in endurance athletes
    Journal of The American Society of Echocardiography, 2012
    Co-Authors: Jan Dhooge, Andre La Gerche, Andrew T Burns, A Macisaac, Hein Heidbuchel, David L Prior
    Abstract:

    Background The significance of reduced right ventricular (RV) deformation reported in endurance athletes (EAs) is unclear, highlighting the ambiguities between physiologic RV remodeling and pathology. The aim of this study was to test the hypothesis that RV functional reserve would be normal in EAs despite reduced deformation measures at rest. Methods Forty EAs and 15 nonathletes (NAs) performed maximal incremental exercise with simultaneous echocardiographic measures of RV function. Two-dimensional (2D) and color-coded Doppler acquisitions were used to quantify peak systolic Strain and Strain Rate (SRs) for the basal, mid, and apical RV free wall. A second surrogate of contractility, the RV end-systolic pressure-area relationship, was calculated from the tricuspid regurgitant velocity and the RV end-systolic area. Changes in multiple measures obtained throughout exercise were used to assess the affect of exercise on RV contractility. Results Compared with NAs at rest, basal RV Strain and SRs were reduced in EAs, with good agreement between 2D and Doppler methods. During exercise, there was a strong linear correlation between heart Rate and global SRs ( r  = −0.74 and r  = −0.84 for Doppler and 2D methods, respectively, P P  = .21 and P  = .97 for differences in mean regression slopes by Doppler and 2D echocardiography, respectively). Exercise-induced increases in the RV end-systolic pressure-area relationship were also similar for EAs and NAs ( P  = .42). There was a strong correlation between RV global SRs and the RV end-systolic pressure-area relationship during exercise ( r  = 0.71, P Conclusions Comparable RV contractile reserve for EAs and NAs suggests that the lower resting values of RV in EAs may represent physiologic changes rather than subclinical myocardial damage.

  • a dual chamber thick walled cardiac phantom for use in cardiac motion and deformation Imaging by ultrasound
    Ultrasound in Medicine and Biology, 2010
    Co-Authors: Beata Lesniakplewinska, Jan Dhooge, K Kaluzynski, Szymon Cygan, Jakub Zmigrodzki, Ewa Kowalik, Maria Kordybach, Mirek Kowalski
    Abstract:

    Abstract Determination of the mechanical properties of the myocardium is crucial for cardiac diagnosis. Cardiac Strain and Strain Rate Imaging may enable such quantification. To further develop these methodologies, an experimental setup allowing the recording of ultrasonic deformation data in a reproducible manner is necessary. Such setup with biventricular polyvinyl alcohol heart phantoms has been built. To test this setup, segmental longitudinal, radial and circumferential displacement, velocity, Strain and Strain Rate in the phantoms were measured using a clinical ultrasound scanner and commercially available deformation Imaging algorithms (based on both tissue velocity Imaging and speckle tracking). The model deformation was close to that observed in the human left ventricular wall and was highly reproducible (e.g., the average peak longitudinal Strain for the mid- and apical phantom segments equals −15.32 ± 0.53% and −19 ± 6% for the ventricle wall). The experimental setup is a valuable source of data for the development of algorithms for deformation estimation. (E-mail: b.lesniak-plewinska@mchtr.pw.edu.pl )

  • improved regional function after autologous bone marrow derived stem cell transfer in patients with acute myocardial infarction a randomized double blind Strain Rate Imaging study
    European Heart Journal, 2008
    Co-Authors: Lieven Herbots, Piet Claus, Jan Dhooge, Javier Ganame, Elif Eroglu, Daisy Thijs, Christophe Dubois, Koen Theunissen, Jan Bogaert, Joseph Dens
    Abstract:

    Aims To investigate whether intracoronary transfer of bone marrow progenitor cells (BMPCs) early after reperfusion of an acute myocardial infarction improves regional myocardial function in a randomized double-blind, placebo-controlled Strain Rate Imaging study. Methods and results Regional myocardial deformation was measured using velocity-derived Strain Rate Imaging in 67 STEMI patients randomized 1:1 to intracoronary infusion of BMPC ( n = 33) or placebo ( n = 34). Myocardial segments were grouped into infarct ( n = 232), border ( n = 250), and remote ( n = 526) based on MRI-delayed enhancement and the perfusion territory of the infarct-related vessel. Four months after revascularization and progenitor cell/placebo transfer, regional myocardial deformation (Rate) improved significantly more in the infarct segments of BMPC patients (treatment effect on end-systolic Strain: −3.7 ± 1.0%, P = 0.0003; peak-systolic Strain Rate: −0.20 ± 0.07 s−1, P = 0.0035). These findings were confirmed by a significantly greater improvement of longitudinal mitral valve ring displacement in the infarct walls of BMPC patients (treatment effect: 0.93 mm, P = 0.034). Conclusion Intracoronary infusion of BMPC early after reperfusion of a STEMI improves recuperation of regional myocardial function at 4 months' follow-up. Quantitative assessment of regional systolic function might be more sensitive than global LV ejection fraction for the evaluation of BMPC therapy after STEMI.

  • Strain Rate Imaging detects early cardiac effects of pegylated liposomal doxorubicin as adjuvant therapy in elderly patients with breast cancer
    Journal of The American Society of Echocardiography, 2008
    Co-Authors: Ruxandra Jurcut, Frank Rademakers, Jan Dhooge, Javier Ganame, Hans Wildiers, Julie De Backer, Hannelore Denys, Robert Paridaens, Jens-uwe Voigt
    Abstract:

    Objective Cardiac toxicity remains an important side effect of anthracyclines. New drug formulations (eg, pegylated liposomal doxorubicin [PL-DOX]) seem to be a successful stRategy for reducing it. Changes in cardiac function induced by early chemotherapy, however, are subtle and difficult to quantitate by conventional Imaging methods. Doppler myocardial Imaging-based velocity, Strain, and Strain Rate measurements have been shown to sensitively quantify abnormalities in cardiac function in other settings. Design We evaluated the feasibility and sensitivity of Strain Rate Imaging compared with conventional echocardiography in detecting cardiac effects of PL-DOX therapy in elderly patients with cancer. In a pilot study, we examined 16 elderly women (age 69.8 ± 3.1 years) with breast cancer receiving 6 cycles of PL-DOX. Conventional and Doppler myocardial Imaging echocardiography were obtained at baseline and after 3 and 6 cycles of treatment. Segmental peak systolic longitudinal and radial velocity, Strain, and Strain Rate were measured. Results Left ventricular dimensions, ejection fraction, and systolic myocardial velocity did not change throughout the follow-up. In contrast, a significant reduction in longitudinal and radial Strain and Strain Rate was found after 6 cycles (longitudinal Strain −18.8% ± 2.8% vs −22.7% ± 2.8%, P P = .001 vs after 3 cycles; radial Strain 32.3% ± 8.1% vs 50.1% ± 11.6%, P Conclusion In contrast with conventional echocardiography and myocardial velocity measurements, myocardial deformation parameters allowed detecting subtle changes in longitudinal and radial left ventricular function after 6 cycles of PL-DOX. We suggest that Doppler-based myocardial deformation Imaging should be used for cardiac function monitoring during chemotherapy.

Bart Bijnens - One of the best experts on this subject based on the ideXlab platform.

  • myocardial deformation abnormalities in patients with aortic regurgitation a Strain Rate Imaging study
    European Journal of Echocardiography, 2009
    Co-Authors: A Marciniak, Piet Claus, Bart Bijnens, G R Sutherland, Maciej Marciniak, Marjan Jahangiri
    Abstract:

    Aims Early left ventricular (LV) dysfunction in asymptomatic patients with severe aortic regurgitation (AR) may go undetected due to the lack of a sufficiently sensitive diagnostic tool. Ultrasonic Strain/ Strain Rate (S/SR) Imaging should now provide such sensitivity in detecting early dysfunction in regional LV systolic deformation. The aim of this study was to understand and define the changes in LV regional systolic deformation based on S/SR Imaging in patients with asymptomatic or minimally symptomatic AR. Methods and results Eighty-one individuals were studied: 59 asymptomatic patients with isolated nonischaemic AR who were divided into three sub-groups such as mild, modeRate, and severe AR and 22 agematched healthy subjects. All patients underwent standard echocardiographic examinations including a tissue Doppler Imaging study. For LV radial deformation, the posterior wall (LVPW) was examined. To assess LV longitudinal deformation, S and SR data were acquired from the LV lateral wall and septum. Radial as well as longitudinal peak systolic SRs were significantly decreased in patients with both modeRate AR (LVPW, P ¼ 0.0009; septum, P ¼ 0.03; LV lateral wall, P ¼ 0.0009) and severe AR (P , 0.0001) compared with healthy subjects. Changes in regional LV deformation correlated inversely both with LV end-diastolic volume and with end-systolic volume. Conclusions Strain Rate Imaging is a sensitive tool in detecting the spectrum of changes in radial and longitudinal deformation in asymptomatic or minimally symptomatic patients with AR. The index where volume was corrected by deformation should form the basis for predicting subclinical LV dysfunction in patients with increasing LV dilatation.

  • changes in systolic left ventricular function in isolated mitral regurgitation a Strain Rate Imaging study
    European Heart Journal, 2007
    Co-Authors: A Marciniak, Piet Claus, Bart Bijnens, G R Sutherland, Maciej Marciniak, T Karu, A Baltabaeva, E Merli, Marjan Jahangiri
    Abstract:

    Aims The aim of the present study is to understand the changes in left ventricular (LV) regional systolic deformation based on Strain Rate (SR) Imaging in patients with isolated mitral regurgitation (MR). Progressive LV dilatation and irreversible myocardial damage as a result of chronic isolated MR are important causes of morbidity and mortality in patients following valve surgery. To date, there is no specific diagnostic method to detect subclinical changes in systolic function before irreversible dysfunction occurs. Methods and results Seventy-seven individuals were studied: 54 asymptomatic patients (age 56 ± 12) with isolated non-ischaemic MR divided into three groups: mild, modeRate, and severe and 23 healthy subjects. All underwent a standard echo examination and a tissue Doppler study. A mathematical study was carried out to predict how SR should alter with increasing dimensions and due to irreversible myocardial damage. Radial as well as longitudinal peak systolic SR was significantly decreased in patients with severe MR compared to the other groups (LV posterior wall: P = 0.0006, septum: P = 0.0004, LV lateral wall: P = 0.0003). From both modelling and in our patients, deformation correlated inversely with LV end-diastolic diameter and end-systolic diameter (ESD). Deformation measurements (corrected for increased geometry) enabled the identification of patients classically referred to as at risk of irreversible myocardial damage (ESD ≥ 4.5 cm). Conclusion In patients with a wide range of MR, deformation remains unchanged due to a balance of increased dimensions and increased stroke volume. Only when contractility is expected to change, deformation will significantly decrease. SR Imaging indices, corrected for geometry, might potentially be useful in detecting subclinical deterioration in LV function in asymptomatic patients with severe MR.

  • regional right ventricular dysfunction in chronic pulmonary hypertension
    Journal of The American Society of Echocardiography, 2007
    Co-Authors: Virginija Dambrauskaite, Piet Claus, Frank Rademakers, Lieven Herbots, Jan Dhooge, Bart Bijnens, Marion Delcroix, George R. Sutherland
    Abstract:

    Objective Right ventricular (RV) failure is the main cause of mortality in patients with pulmonary hypertension (PH). Therefore, there is an increasing interest for the assessment of RV function. This study aimed to evaluate the regional RV function in patients with PH by using ultrasonic Strain Rate Imaging. Methods In all, 27 patients with PH and 27 control subjects were studied by ultrasonic Strain Rate Imaging. The regional longitudinal deformation was measured in the RV free wall divided into two segments. A subgroup of 16 patients had concomitant invasive hemodynamic measurements. Results In patients with PH, deformation parameters were significantly lower compared with that of control subjects (basal Strain Rate −2.28 ± 0.9 vs −2.94 ± 0.9 s −1 ; Strain −28 ± 13% vs −42 ± 11%; apical Strain Rate −1.05 ± 1.38 vs −2.60 ± 0.9 s −1 ; Strain −13 ± 16% vs −41 ± 11%, respectively). The deformation parameters in the apical segment were reduced more than in the basal segment (the segment-wise comparison with P P R = 0.82, P R = 0.73, P Conclusion Strain Rate Imaging provides a new tool to quantify regional RV dysfunction in patients with PH and reveals a characteristic regional pattern of abnormal RV free wall function.

  • the potential clinical role of ultrasonic Strain and Strain Rate Imaging in diagnosing acute rejection after heart transplantation
    European Journal of Echocardiography, 2007
    Co-Authors: A Marciniak, Piet Claus, Lieven Herbots, Jan Dhooge, Bart Bijnens, Elif Eroglu, M Marciniak, Cristina Sirbu, Walter Droogne, Johan Vanhaecke
    Abstract:

    Background There has been a continued search for a more sensitive noninvasive technique for detecting sub-clinical acute rejection in heart transplant recipients. Ultrasonic deformation Imaging (Strain/Strain Rate) is sensitive in detecting sub-clinical abnormalities in regional systolic function and could potentially be sufficiently sensitive to detect changes in deformation induced by graft rejection. Aim To assess the use of Strain (S) and Strain Rate (SR) Imaging as a noninvasive method for monitoring and diagnosing acute rejection in heart transplant recipients. Methods and results A prospective preliminary study was carried out involving 31 consecutive heart transplant patients who underwent a total of 106 routine follow up endomyocardial biopsy with correlative cardiac ultrasound data. To assess regional longitudinal deformation, ultrasonic S and SR data were acquired from the intraventricular septum, left ventricular (LV) lateral and right ventricular free walls (RVFW). For radial deformation, data were obtained from the LV posterior wall (LVPW). According to the International Society of Heart and Lung Transplantation criteria, 88 biopsies (Group 1) had grade 0 or IA rejection, and 18 biopsies (Group 2) had ≥grade IB rejection. Longitudinal peak systolic S and SR were decreased ( p <0.05) in Group 2, compared to Group 1 in the RVFW basal and apical segments and the basal and mid segments of the LV lateral wall. Radial peak systolic S and SR were significantly lower ( p <0.001) in Group 2, compared to Group 1. Conclusions S/SR Imaging might be a good technique and an additional tool for detecting ≥IB grade of acute rejection. The myocardial deformation, as assessed by S/SR Imaging could be of clinical value in monitoring and diagnosing acute rejection in heart transplant recipients and could improve patients' management by reducing the number of biopsies performed.

  • feasibility of Strain and Strain Rate Imaging for the assessment of regional left atrial deformation a study in normal subjects
    European Journal of Echocardiography, 2006
    Co-Authors: C Sirbu, Piet Claus, Frank Rademakers, Lieven Herbots, Jan Dhooge, Bart Bijnens, A Marciniak, T Langeland, G R Sutherland
    Abstract:

    Aims: There are no data on the use of Myocardial Velocity Imaging (MVI) to study the left atrium (LA) wall deformation. The aims of this study were to assess the feasibility of measuring regional longitudinal Strain/Strain Rate (3/SR) profiles in the LA wall, to define the normal values and to validate these measurements. Methods and results: MVI data were recorded in 40 healthy young individuals using a GE Vivid7 for the lateral, anterior and inferior LA walls. The peak 3/SR values and total3valuesduringthecontractile,reservoirandconduitLAphases weremeasured. For the LA lateral wall, the total 3 values were correlated with the LA volumetric indicators (LA active emptying fraction: LA AEF; LA expansion index: LA EI; and LA passive emptying fraction: LA PEF). The correlations were significant for all three periods: contractile (total 3 vs. LA AEF, rZ� 0.78, P!0.001), reservoir (total 3 vs. LA EI, rZ0.43, P!0.01) and conduit (total 3 vs. LA PEF, rZ� 0.46, P!0.005). Conclusion: SR/3 Imaging for the quantification of longitudinal myocardial LA deformation was shown to be feasible and the normal values were reported and validated. These data may improve the understanding of the LA pathophysiology. a 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

Giovanni Di Salvo - One of the best experts on this subject based on the ideXlab platform.

  • abnormal myocardial deformation properties in obese non hypertensive children an ambulatory blood pressure monitoring standard echocardiographic and Strain Rate Imaging study
    European Heart Journal, 2006
    Co-Authors: Giovanni Di Salvo, Giuseppe Pacileo, Alessandra Rea, Marina Verrengia, Emanuele Miraglia Del Giudice, Francesco Natale, Giuseppe Limongelli, Fiorella Fratta, Biagio Castaldi, Antonello Dandrea
    Abstract:

    Aims The prevalence of obesity is increasing among children in the developed world. The association of obesity and abnormal cardiac function is still debated. The reported changes may reflect the role of comorbidities that contribute to ventricular dysfunction. Obese children, without arterial hypertension, may be a unique clinical opportunity to evaluate the effect of obesity, per se , on myocardial function, excluding the influence of possible comorbidities. We sought to define the preclinical effects of obesity on the cardiovascular system, of healthy children with excess weight who have no other clinically appreciable cause of heart disease, using the more sensitive ultrasonic-derived Strain and Strain Rate (SR) Imaging. Methods and results We studied 300 subjects divided into two groups: (i) obese children (Group O: n =150; age, 12±3 years); (ii) healthy lean children comparable for age, sex, and pubertal stage (Referents: n =150; mean age, 12±3 years). Systolic (SBP) and diastolic blood pressure (DBP), as well as 24 h-SBP and 24 h-DBP were comparable between groups. Left ventricular (LV) mass/height2.7 was increased ( P <0.0001) in Group O (46±12 g/m2.7) when compared with Referents (31±14 gm2.7). Standard echocardiographic indices of global systolic function were similar in the two groups. Intima-media thickness measured at the common carotid artery was not significantly different ( P =0.4) in obese children (0.46±0.09 mm) when compared with Referents (0.45±0.07 mm). Obese children showed regional longitudinal peak systolic myocardial deformation properties (SR=−1.4±0.7 s−1) lower ( P <0.0001) than those of Referents (SR=−2.2±0.5) in both left and right ventricle. In multivariable analysis, average peak systolic SR was significantly correlated with homeostasis model assessment of insulin resistance ( P <0.01; coefficient, 0.02; SE, 0.011), and insulin serum concentration ( P <0.01; coefficient, 0.05; SE, 0.023). Average LV peak systolic Strain was significantly correlated with body mass index ( P =0.0001; coefficient, 0.06; SE, 0.016), LVM/H2.7 ( P =0.006; coefficient, 0.016; SE, 0.018). Conclusions Our study demonstRated that obesity, in absence of hypertension, is associated with significant reduction in systolic myocardial deformation properties already in childhood involving both right and left ventricle. Obesity not only is a risk factor for later cardiovascular disease, but also is associated with contemporaneous and significant impairment of longitudinal myocardial deformation properties.

  • atrial function after surgical and percutaneous closure of atrial septal defect a Strain Rate Imaging study
    Journal of The American Society of Echocardiography, 2005
    Co-Authors: Giovanni Di Salvo, Manuela Drago, Giuseppe Pacileo, Alessandra Rea, Marianna Carrozza, Giuseppe Santoro, Maurizio Cappelli Bigazzi, Pio Caso, Maria Giovanna Russo, Mario Carminati
    Abstract:

    The effect of operation and the effect of the imposition of an occluding device on atrial function for patients with an atrial septal defect (ASD) has never been studied. Thus, the aim of this study was to evaluate for the first time both left atrial (LA) and right atrial (RA) function of children after transcatheter ASD closure with that of sex- and age-matched patients with surgically treated ASD, and sex- and age-matched control subjects using Strain (ϵ) and ϵ Rate Imaging (SR). In all, 45 participants formed our studied sample: 15 patients after successful ASD device closure (ASD-D [atrial septal defect device closure] group, mean age: 9 ± 3 years) and 15 age- and sex-matched patients after successful ASD surgical closure (ASD-S [atrial septal defect surgical closure] group, mean age: 9 ± 3 years). All patients underwent ASD correction at least 6 months before the study. As a control group we selected 15 age- and sex-matched control subjects. In the ASD-S group the peak systolic ϵ and SR values were significantly reduced in both RA and LA when compared with control and ASD-D groups ( P

  • atrial myocardial deformation properties predict maintenance of sinus rhythm after external cardioversion of recent onset lone atrial fibrillation a color doppler myocardial Imaging and transthoracic and transesophageal echocardiographic study
    Circulation, 2005
    Co-Authors: Giovanni Di Salvo, Pio Caso, Maria Giovanna Russo, Rosalia Lo Piccolo, Angela Fusco, A R Martiniello, Antonio Donofrio, Sergio Severino, Paolo Calabro, Giuseppe Pacileo
    Abstract:

    Background— AccuRate echocardiographic parameters to predict maintenance of sinus rhythm in patients with atrial fibrillation (AF) are poorly defined. This study was conducted to assess the atrial myocardial properties during AF through myocardial velocity, Strain Rate, and Strain and to compare their prognostic value in maintaining sinus rhythm in patients with lone AF with standard transthoracic (TTE) and transesophageal echocardiography (TEE). Methods and Results— Sixty-five consecutive patients with lone AF for ≤3 months underwent TTE, TEE, and myocardial velocity and Strain and Strain Rate Imaging examinations before successful external cardioversion. Maintenance of sinus rhythm was assessed during a 9-month follow-up. Atrial myocardial velocity, Strain, and Strain Rate values in AF patients were compared with those of age- and sex-matched referents. Moreover, clinical and echocardiographic parameters of patients with maintenance of sinus rhythm (MSR patients) over the 9-month follow-up period (n=25)...

  • comparison of Strain Rate Imaging for quantitative evaluation of regional left and right ventricular function after surgical versus percutaneous closure of atrial septal defect
    American Journal of Cardiology, 2005
    Co-Authors: Giovanni Di Salvo, Manuela Drago, Giuseppe Pacileo, Marianna Carrozza, Giuseppe Santoro, Maurizio Cappelli Bigazzi, Pio Caso, Maria Giovanna Russo, Mario Carminati, Raffaele Calabro
    Abstract:

    For the first time, peak systolic Strain and Strain Rate (SR) were used to assess right ventricular (RV) and left ventricular (LV) regional function in children after transcatheter and surgical atrial septal defect (ASD) closure. Fifteen patients with successful ASD device closure (the ASD-D group, mean age 9 ± 3 years), 15 age- and gender-matched patients with successful ASD surgical closure (the ASD-S group, mean age 9 ± 3 years), and 15 age- and gender-matched controls were enrolled. Regional RV and LV longitudinal function was significantly reduced in the ASD-S group compared with controls in all the studied segments. The ASD-D group presented significantly (p

  • Strain Rate Imaging is a superior method for the assessment of regional myocardial function compared with doppler tissue Imaging a study on patients with transcatheter device closure of atrial septal defect
    Journal of The American Society of Echocardiography, 2005
    Co-Authors: Giovanni Di Salvo, Giuseppe Pacileo, Alessandra Rea, Giuseppe Santoro, Pio Caso, Maria Giovanna Russo, Marina Verrengia, Raffaele Calabro
    Abstract:

    To compare the value of Strain and Strain Rate Imaging in assessing regional myocardial function to that of myocardial velocities, we studied 10 patients late after successful percutaneous atrial septal defect closure. Analysis was performed for atrial longitudinal peak systolic velocity, Strain, and Strain Rate from the midsegment of interatrial septum, in correspondence of the device, and from the lateral left atrial wall. Placing the sample volume in the middle part of the atrial septal defect occluder, a bulky noncontractile element, passively moved by global heart motion, the new ultrasonic-derived myocardial deformation indexes demonstRated almost the absence of any deformations, whereas myocardial velocities failed to significantly discriminate between this noncontracting structure and the normal atrial wall.

Piet Claus - One of the best experts on this subject based on the ideXlab platform.

  • myocardial deformation abnormalities in patients with aortic regurgitation a Strain Rate Imaging study
    European Journal of Echocardiography, 2009
    Co-Authors: A Marciniak, Piet Claus, Bart Bijnens, G R Sutherland, Maciej Marciniak, Marjan Jahangiri
    Abstract:

    Aims Early left ventricular (LV) dysfunction in asymptomatic patients with severe aortic regurgitation (AR) may go undetected due to the lack of a sufficiently sensitive diagnostic tool. Ultrasonic Strain/ Strain Rate (S/SR) Imaging should now provide such sensitivity in detecting early dysfunction in regional LV systolic deformation. The aim of this study was to understand and define the changes in LV regional systolic deformation based on S/SR Imaging in patients with asymptomatic or minimally symptomatic AR. Methods and results Eighty-one individuals were studied: 59 asymptomatic patients with isolated nonischaemic AR who were divided into three sub-groups such as mild, modeRate, and severe AR and 22 agematched healthy subjects. All patients underwent standard echocardiographic examinations including a tissue Doppler Imaging study. For LV radial deformation, the posterior wall (LVPW) was examined. To assess LV longitudinal deformation, S and SR data were acquired from the LV lateral wall and septum. Radial as well as longitudinal peak systolic SRs were significantly decreased in patients with both modeRate AR (LVPW, P ¼ 0.0009; septum, P ¼ 0.03; LV lateral wall, P ¼ 0.0009) and severe AR (P , 0.0001) compared with healthy subjects. Changes in regional LV deformation correlated inversely both with LV end-diastolic volume and with end-systolic volume. Conclusions Strain Rate Imaging is a sensitive tool in detecting the spectrum of changes in radial and longitudinal deformation in asymptomatic or minimally symptomatic patients with AR. The index where volume was corrected by deformation should form the basis for predicting subclinical LV dysfunction in patients with increasing LV dilatation.

  • improved regional function after autologous bone marrow derived stem cell transfer in patients with acute myocardial infarction a randomized double blind Strain Rate Imaging study
    European Heart Journal, 2008
    Co-Authors: Lieven Herbots, Piet Claus, Jan Dhooge, Javier Ganame, Elif Eroglu, Daisy Thijs, Christophe Dubois, Koen Theunissen, Jan Bogaert, Joseph Dens
    Abstract:

    Aims To investigate whether intracoronary transfer of bone marrow progenitor cells (BMPCs) early after reperfusion of an acute myocardial infarction improves regional myocardial function in a randomized double-blind, placebo-controlled Strain Rate Imaging study. Methods and results Regional myocardial deformation was measured using velocity-derived Strain Rate Imaging in 67 STEMI patients randomized 1:1 to intracoronary infusion of BMPC ( n = 33) or placebo ( n = 34). Myocardial segments were grouped into infarct ( n = 232), border ( n = 250), and remote ( n = 526) based on MRI-delayed enhancement and the perfusion territory of the infarct-related vessel. Four months after revascularization and progenitor cell/placebo transfer, regional myocardial deformation (Rate) improved significantly more in the infarct segments of BMPC patients (treatment effect on end-systolic Strain: −3.7 ± 1.0%, P = 0.0003; peak-systolic Strain Rate: −0.20 ± 0.07 s−1, P = 0.0035). These findings were confirmed by a significantly greater improvement of longitudinal mitral valve ring displacement in the infarct walls of BMPC patients (treatment effect: 0.93 mm, P = 0.034). Conclusion Intracoronary infusion of BMPC early after reperfusion of a STEMI improves recuperation of regional myocardial function at 4 months' follow-up. Quantitative assessment of regional systolic function might be more sensitive than global LV ejection fraction for the evaluation of BMPC therapy after STEMI.

  • changes in systolic left ventricular function in isolated mitral regurgitation a Strain Rate Imaging study
    European Heart Journal, 2007
    Co-Authors: A Marciniak, Piet Claus, Bart Bijnens, G R Sutherland, Maciej Marciniak, T Karu, A Baltabaeva, E Merli, Marjan Jahangiri
    Abstract:

    Aims The aim of the present study is to understand the changes in left ventricular (LV) regional systolic deformation based on Strain Rate (SR) Imaging in patients with isolated mitral regurgitation (MR). Progressive LV dilatation and irreversible myocardial damage as a result of chronic isolated MR are important causes of morbidity and mortality in patients following valve surgery. To date, there is no specific diagnostic method to detect subclinical changes in systolic function before irreversible dysfunction occurs. Methods and results Seventy-seven individuals were studied: 54 asymptomatic patients (age 56 ± 12) with isolated non-ischaemic MR divided into three groups: mild, modeRate, and severe and 23 healthy subjects. All underwent a standard echo examination and a tissue Doppler study. A mathematical study was carried out to predict how SR should alter with increasing dimensions and due to irreversible myocardial damage. Radial as well as longitudinal peak systolic SR was significantly decreased in patients with severe MR compared to the other groups (LV posterior wall: P = 0.0006, septum: P = 0.0004, LV lateral wall: P = 0.0003). From both modelling and in our patients, deformation correlated inversely with LV end-diastolic diameter and end-systolic diameter (ESD). Deformation measurements (corrected for increased geometry) enabled the identification of patients classically referred to as at risk of irreversible myocardial damage (ESD ≥ 4.5 cm). Conclusion In patients with a wide range of MR, deformation remains unchanged due to a balance of increased dimensions and increased stroke volume. Only when contractility is expected to change, deformation will significantly decrease. SR Imaging indices, corrected for geometry, might potentially be useful in detecting subclinical deterioration in LV function in asymptomatic patients with severe MR.

  • regional right ventricular dysfunction in chronic pulmonary hypertension
    Journal of The American Society of Echocardiography, 2007
    Co-Authors: Virginija Dambrauskaite, Piet Claus, Frank Rademakers, Lieven Herbots, Jan Dhooge, Bart Bijnens, Marion Delcroix, George R. Sutherland
    Abstract:

    Objective Right ventricular (RV) failure is the main cause of mortality in patients with pulmonary hypertension (PH). Therefore, there is an increasing interest for the assessment of RV function. This study aimed to evaluate the regional RV function in patients with PH by using ultrasonic Strain Rate Imaging. Methods In all, 27 patients with PH and 27 control subjects were studied by ultrasonic Strain Rate Imaging. The regional longitudinal deformation was measured in the RV free wall divided into two segments. A subgroup of 16 patients had concomitant invasive hemodynamic measurements. Results In patients with PH, deformation parameters were significantly lower compared with that of control subjects (basal Strain Rate −2.28 ± 0.9 vs −2.94 ± 0.9 s −1 ; Strain −28 ± 13% vs −42 ± 11%; apical Strain Rate −1.05 ± 1.38 vs −2.60 ± 0.9 s −1 ; Strain −13 ± 16% vs −41 ± 11%, respectively). The deformation parameters in the apical segment were reduced more than in the basal segment (the segment-wise comparison with P P R = 0.82, P R = 0.73, P Conclusion Strain Rate Imaging provides a new tool to quantify regional RV dysfunction in patients with PH and reveals a characteristic regional pattern of abnormal RV free wall function.

  • the potential clinical role of ultrasonic Strain and Strain Rate Imaging in diagnosing acute rejection after heart transplantation
    European Journal of Echocardiography, 2007
    Co-Authors: A Marciniak, Piet Claus, Lieven Herbots, Jan Dhooge, Bart Bijnens, Elif Eroglu, M Marciniak, Cristina Sirbu, Walter Droogne, Johan Vanhaecke
    Abstract:

    Background There has been a continued search for a more sensitive noninvasive technique for detecting sub-clinical acute rejection in heart transplant recipients. Ultrasonic deformation Imaging (Strain/Strain Rate) is sensitive in detecting sub-clinical abnormalities in regional systolic function and could potentially be sufficiently sensitive to detect changes in deformation induced by graft rejection. Aim To assess the use of Strain (S) and Strain Rate (SR) Imaging as a noninvasive method for monitoring and diagnosing acute rejection in heart transplant recipients. Methods and results A prospective preliminary study was carried out involving 31 consecutive heart transplant patients who underwent a total of 106 routine follow up endomyocardial biopsy with correlative cardiac ultrasound data. To assess regional longitudinal deformation, ultrasonic S and SR data were acquired from the intraventricular septum, left ventricular (LV) lateral and right ventricular free walls (RVFW). For radial deformation, data were obtained from the LV posterior wall (LVPW). According to the International Society of Heart and Lung Transplantation criteria, 88 biopsies (Group 1) had grade 0 or IA rejection, and 18 biopsies (Group 2) had ≥grade IB rejection. Longitudinal peak systolic S and SR were decreased ( p <0.05) in Group 2, compared to Group 1 in the RVFW basal and apical segments and the basal and mid segments of the LV lateral wall. Radial peak systolic S and SR were significantly lower ( p <0.001) in Group 2, compared to Group 1. Conclusions S/SR Imaging might be a good technique and an additional tool for detecting ≥IB grade of acute rejection. The myocardial deformation, as assessed by S/SR Imaging could be of clinical value in monitoring and diagnosing acute rejection in heart transplant recipients and could improve patients' management by reducing the number of biopsies performed.