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Aims: To observe the ventricular global and regional function of the patients with systemic amyloidosis using two-dimensional speckle tracking echocardiography. Methods: The study enrolled 31 consecutive biopsy-proved patients with systemic amyloidosis who underwent echocardiographic examination and EF > 55% and 37 age- and gender-matched healthy controls. We compared systolic strain and strain rate, diastolic strain rate, time to peak strain, peak delay time in longitudinal, radial, circumferential directions in 16 left ventricular segments. The global peak systolic longitudinal and radial strain of left ventricle, peak systolic longitudinal strain and strain rate, diastolic strain rate of right ventricular free wall were also compared. Results: (1) Global peak systolic longitudinal strain (GPSLS), peak systolic longitudinal strain (PSLS) and strain rate (PSLSR), peak early diastolic longitudinal strain rate (PELSR) in 16 segments were decreased in case (P < 0.05). (2) Peak systolic radial strain and strain rate of inferoseptum and inferolateral at the level of papillary muscle were lower (P < 0.05), and peak early diastolic radial strain rate (PERSR) was reduced (P < 0.05). (3) Peak early diastolic circumferential strain rate was lower (P < 0.05). (4) Time to peak systolic longitudinal, radial, circumferential strain was longer, and peak delay time at the same level retarded (P < 0.05). (5) Into right ventricular wall, PSLS and PSLSR at midsegment, and PSLSR, PELSR, peak atrial systolic longitudinal strain rate (PALSR) at basal were reduced (P < 0.05). (6) Inverse correlation between interventricular septum (IVS) thickness and GPSLS and GPSRS was found (P < 0.05). Conclusion: Systolic and diastolic dysfunction existed in systemic amyloidosis with preserved EF. Mechanical contraction disorder may be one reason for systolic dysfunction. GPLSR and GPRSR were negatively related to IVS thickness. [ABSTRACT FROM AUTHOR]

Objective To compare three-dimensional (3D) and two-dimensional (2D) speckle tracking echocardiography ( STE) techniques in the assessment of left ventricular function and myocardial infarct size ( MIS). Methods Thirty-two patients diagnosed with ST elevation myocardial infarction and 18 healthy control patients underwent 2D echocardiography, 3D echocardiography, and single photon emission computed tomography ( SPECT). 3D left ventricular global area strain ( GAS), 2D and 3D global longitudinal strain ( GLS), global radial strain ( GRS) as well as global circumferential strain ( GCS) were analyzed to correlate with myocardial infarct size detected by SPECT. 2D and 3D left ventricular ejection fraction ( LVEF) as well as 2D and 3D wall motion score index ( WMSI) also were measured using conventional echocardiography. Results The 2D- GLS values were significantly higher than that of 3D- GLS, while 2D- GCS and GRS were significantly lower than 3D- GCS and GRS, respectively. However, no significant differences in LVEF and WMSI could be observed between 2D and 3D echocardiography. Myocardial strain indices, LVEF, and WMSI using 2D and 3D echocardiography also had good correlations with MIS as measured by SPECT. ROC curve analysis showed that the 3D and 2D myocardial indices, LVEF, and WMSI could distinguish between small and large MIS, while 2D- GLS had the highest AUC. Conclusion The 2D and 3D myocardial strain indices correlated well with MIS by SPECT. Among them, the 2D- GLS showed the highest diagnostic value, while 3D- GRS and GCS had better diagnostic value than 2D- GRS and GCS. [ABSTRACT FROM AUTHOR]

Background Published correlations between histological abnormalities and right ventricular (RV) function, as evaluated by speckle tracking echocardiography (STE), are scarce in patients with tetralogy of Fallot (TOF). The purpose of the study is to assess age-associated differences in the effect of RV myocardial remodeling on ventricular function in patients with TOF. Methods Operatively resected crista supraventricularis muscle from 30 patients (median age 12 months) undergoing intracardiac repair of TOF were studied by light microscopy. The patients were divided into younger (age at surgery ≤ 12 months) and older (age at surgery > 12 months) subgroups. The RV global longitudinal peak systolic strain (GLS), strain rate (GLSRs) and early diastolic strain rate (GLSRe) were measured by two-dimensional STE before and 6 months after repair. Results The histopathological data revealed hypertrophy of the cardiomyocytes, a thickened endocardium, and increased interstitial and perivascular collagen in RV, which were associated with older age at the time of repair. The RV global systolic and diastolic functions in patients with repaired TOF were increased compared with the preoperative values. The RV cardiomyocyte diameter and collagen volume fraction (CVF) correlated with the preoperative GLS, GLSRs and GLSRe, respectively, in the younger patients (r1 = - 0.566, P1 = 0.018; r2 = - 0.493, P2 = 0.004; r3 = - 0.504, P3 = 0.039). The RV cardiomyocyte diameter and CVF correlated with preoperative GLS, GLSRs and GLSRe, respectively, in the older patients (r1 = - 737, P1 = 0.004; r2 = - 0.588, P2 = 0.035; r3 = - 0.812, P3 = 0.001). The correlation of the RV cardiomyocyte diameter with the postoperative GLS and GLSRe (r1 = - 665, P1 = 0.036; r2 = - 0.787, P2 = 0.007) and the CVF with the postoperative GLSRs and GLSRe (r1 = - 762, P1 = 0.002; r2 = - 0.713, P2 = 0.004) were identified only in the older patients. Multivariate analysis indicated that the age at repair was an independent predictor of postoperative GLSRs and GLSRe in all of the patients (β = - 0.449, P = 0.041; β = - 0.607, P = 0.004). Conclusions The effect of RV myocardial remodeling on preoperative RV function was more pronounced in the older patients with TOF than in the younger ones. Preoperative myocardial remodeling affected the postoperative RV function in the older but not in the younger patients. The age at the time of surgical repair was the independent determinant of the postoperative RV myocardial function. [ABSTRACT FROM AUTHOR]