Search

Objective: Psoriasis, which is a chronic inflammatory disease is associated with an increased risk of cardiovascular (CV) diseases (CVD). Currently, no method is available to evaluate subclinical CV dysfunction in patients with psoriasis. The aim of the study was to evaluate left ventricular (LV) function in patients with untreated psoriasis but no risk factors for CV disease (CVD). Material and Methods: Thirty patients with psoriasis without any CVD or risk factors for CVD and 20 age- and gender-matched controls were recruited. All patients underwent detailed transthoracic echocardiography, including speckle tracking-derived strain analysis. Results: Speckle tracking echocardiography showed significantly lower global circumferential strain in psoriatic patients compared to healthy controls (mean ±SD: -23.34±6.74% vs. -27.53±4.11%, respectively, p<0.001). No significant differences were found in terms of global longitudinal strain, aortic flow velocity, pulmonary arterial flow velocity, LV end-systolic volume, LV end-diastolic volume, LV ejection fraction, peak of early diastolic (E) and late diastolic (A) flow velocity, E/A ratio, and levels of biochemical markers, including C-reactive protein, between the patients and controls (p>0.05). Conclusion: Subclinical myocardial dysfunction was seen in the patients with psoriasis who had no conventional risk factors for CVD using two-dimensional strain imaging. We believe that this imaging technique may be useful for early detection of CVD development in patients with psoriasis. [ABSTRACT FROM AUTHOR]

New Findings: What is the central question of this study? Common carotid artery (CCA) two‐dimensional strain imaging detects intrinsic arterial wall properties beyond conventional measures of arterial stiffness, but the effect of cardiorespiratory fitness on two‐dimensional strain‐derived indices of CCA stiffness is unknown. What is the main finding and its importance? Two‐dimensional strain imaging of the CCA revealed greater peak circumferential strain and systolic strain rate in highly fit men compared with their less fit counterparts. Altered CCA wall mechanics might reflect intrinsic training‐induced adaptations that help to buffer the increase in pulse pressure and stroke volume during exercise. Abstract: The influence of cardiorespiratory fitness on arterial stiffness in young adults remains equivocal. Beyond conventional measures of arterial stiffness, two‐dimensional strain imaging of the common carotid artery (CCA) provides new information related to the intrinsic properties of the arterial wall. Therefore, the aim of this study was to assess the effect of cardiorespiratory fitness on both conventional indices of CCA stiffness and two‐dimensional strain parameters, at rest and after a bout of aerobic exercise in young, healthy men. Short‐axis ultrasound images of the CCA were recorded in 34 healthy men {22 years old [95% confidence interval (CI), 19, 22]} before and immediately after 5 min of aerobic exercise (40% of maximal oxygen consumption). Images were analysed for arterial diameter, peak circumferential strain (PCS) and peak systolic and diastolic strain rates (S‐SR and D‐SR). Heart rate, systolic and diastolic blood pressure were simultaneously assessed, and Peterson's elastic modulus (Ep) and β‐stiffness (β1) were calculated. Participants were separated post hoc into moderate‐ and high‐fitness groups [maximal oxygen consumption, 48.9 (95% CI, 44.7, 53.2) versus 65.6 ml kg−1 min−1 (95% CI, 63.1, 68.1), respectively; P < 0.001]. The Ep and β1 were similar between groups at baseline (P > 0.13) but were elevated in the moderate‐fitness group postexercise (P < 0.04). The PCS and S‐SR were elevated in the high‐fitness group at both time points [3.0% (95% CI, 1.2, 4.9), P = 0.002, and 0.401 s−1 (95% CI, 0.085, 0.72), P = 0.02, respectively]. No group differences were observed in CCA heart rate, systolic or diastolic blood pressure or D‐SR throughout the protocol (P > 0.05). Highly fit individuals exhibit elevated CCA, PCS and S‐SR, which might reflect training‐induced adaptations that help to buffer the increase in pulse pressure and stroke volume during exercise. [ABSTRACT FROM AUTHOR]

Aims Transcatheter aortic valve implantation ( TAVI) is an alternative treatment in surgically high-risk or inoperable patients with severe aortic stenosis ( AS). The objective of this study was to analyze the effects of TAVI on left ventricular ( LV) and left atrial ( LA) longitudinal function assessed by speckle tracking echocardiography (2 DSTE) in patients with AS. Methods In our prospectively conducted study, a total of 55 symptomatic ( New York Heart Association class II or higher) patients with severe AS, considered to be at increased risk for undergoing surgical aortic valve replacement, were recruited (age: 78.6 ± 7.4 year). Patients underwent a complete clinical and laboratory evaluation, in addition to standard echocardiography and 2 DSTE. Echocardiographic analysis was performed before and 6 months after TAVI. 2 DSTE measured segmental and global longitudinal strain ( GLS) and radial strain. Results All the patients received the CoreValve self-expanding prosthesis. Six months after TAVI, patients showed a significant reduction in mean transaortic gradient (52.1 ± 15.8 vs. 11.2 ± 3.3 mmHg, P < 0.0001), LV mass, LA volume index, and an improvement of ejection fraction (P < 0.0001). In addition, LV GLS (−11.8 ± 3.2 vs. −16.3 ± 4.2%; P < 0.0001) and LA longitudinal strain (14.2 ± 5.4 vs. 26.6 ± 10.8%, P < 0.0001) significantly increased after TAVI. In a stepwise forward multiple logistic regression analysis, LV mass before TAVI (P < 0.001) and peak CK MB mass after TAVI (P < 0.0001) were powerful independent predictors of lower improvement of LV GLS. Moreover, LV mass index (P < 0.001) and LV GLS strain (P < 0.001) before TAVI were powerful independent predictor of LA longitudinal strain after TAVI Conclusions TAVI in patients with AS resulted in geometric changes known as 'reverse remodelling,' and improved LV and LA function assessed by 2 DSTE. [ABSTRACT FROM AUTHOR]

Aims To investigate the prognostic impact of left-ventricular (LV) cardiac magnetic resonance (CMR) deformation imaging in patients with non-ischaemic dilated cardiomyopathy (DCM) compared with late-gadolinium enhancement (LGE) quantification and LV ejection fraction (EF). Methods and results A total of 210 subjects with DCM were examined prospectively with standard CMR including measurement of LGE for quantification of myocardial fibrosis and feature tracking strain imaging for assessment of LV deformation. The predefined primary endpoint, a combination of cardiac death, heart transplantation, and aborted sudden cardiac death, occurred in 26 subjects during the median follow-up period of 5.3 years. LV radial, circumferential, and longitudinal strains were significantly associated with outcome. Using separate multivariate analysis models, global longitudinal strain (average of peak negative strain values) and mean longitudinal strain (negative peak of the mean curve of all segments) were independent prognostic parameters surpassing the value of global and mean LV radial and circumferential strain, as well as NT-pro BNP, EF, and LGE mass. A global longitudinal strain greater than –12.5% predicted outcome even in patients with EF < 35%(P < 0.01) and in those with presence of LGE (P < 0.001). Mean longitudinal strain was further investigated using a clinical model with predefined cut-offs (EF < 35%, presence of LGE, NYHA class, mean longitudinal strain greater than –10%). Mean longitudinal strain exhibited an independent prognostic value surpassing that provided by NYHA, EF, and LGE (HR = 5.4, P < 0.01). Conclusion LV longitudinal strain assessed with CMR is an independent predictor of survival in DCM and offers incremental information for risk stratification beyond clinical parameters, biomarker, and standard CMR. [ABSTRACT FROM AUTHOR]

Aims: To investigate the prognostic impact of left-ventricular (LV) cardiac magnetic resonance (CMR) deformation imaging in patients with non-ischaemic dilated cardiomyopathy (DCM) compared with late-gadolinium enhancement (LGE) quantification and LV ejection fraction (EF)., Methods and Results: A total of 210 subjects with DCM were examined prospectively with standard CMR including measurement of LGE for quantification of myocardial fibrosis and feature tracking strain imaging for assessment of LV deformation. The predefined primary endpoint, a combination of cardiac death, heart transplantation, and aborted sudden cardiac death, occurred in 26 subjects during the median follow-up period of 5.3 years. LV radial, circumferential, and longitudinal strains were significantly associated with outcome. Using separate multivariate analysis models, global longitudinal strain (average of peak negative strain values) and mean longitudinal strain (negative peak of the mean curve of all segments) were independent prognostic parameters surpassing the value of global and mean LV radial and circumferential strain, as well as NT-proBNP, EF, and LGE mass. A global longitudinal strain greater than -12.5% predicted outcome even in patients with EF < 35% (P < 0.01) and in those with presence of LGE (P < 0.001). Mean longitudinal strain was further investigated using a clinical model with predefined cut-offs (EF < 35%, presence of LGE, NYHA class, mean longitudinal strain greater than -10%). Mean longitudinal strain exhibited an independent prognostic value surpassing that provided by NYHA, EF, and LGE (HR = 5.4, P < 0.01)., Conclusion: LV longitudinal strain assessed with CMR is an independent predictor of survival in DCM and offers incremental information for risk stratification beyond clinical parameters, biomarker, and standard CMR., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.)