Search

Aims: Heart failure is known as a health problem in the world due to its mortality and burdens on the health care system. Studies remain controversial about the effect of opium usage on systolic heart function. Therefore, the aim of this study was to compare systolic left ventricular function in opium users with non‐addict people by strain echocardiography and its association with serum apelin level. Methods: This case–control study was conducted in 2022 at Shafa Hospital in Kerman, Iran, on 50 opium users who referred to the addiction treatment centres and had no history of other substance usage. The addiction is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) and a history of opium consumption for at least 3 years. Fifty healthy people (non‐opium users) who were matched in terms of age and sex were enrolled as a control group. Demographic information of the participants, including age, gender and amount of opium usage, was recorded by questionnaire. Citrated blood samples were taken from all participants in the study, and serum apelin was measured by the enzyme‐linked immunosorbent assay (ELISA) method. They underwent transthoracic echocardiography by an expert cardiologist using the same device (Philips Affiniti 50). Echocardiographic systolic parameters have been recorded and compared between the two groups. Results: In this study, 100 participants, including 50 opium users and 50 non‐opium users (as a control group), were investigated. The mean age was 36.4 ± 5.08 in the opium users' group and 34.14 ± 7.2 in the control group. As both groups were matched, there were 8 (16%) women and 42 (84%) men in each of the two groups. The mean amount of ejection fraction (EF) and global longitudinal strain (GLS) were significantly lower in opium users than in the control group (P < 0.001). The results also demonstrated that the serum level of apelin in the addicted persons was lower when compared with the non‐addicted persons (3.4 vs. 9.7; P < 0.001). Conclusions: Evaluation of systolic left ventricular function in opium users by strain echocardiography showed that opium affects the systolic function of the heart, as observed by a significant reduction in EF and GLS. So opium usage can be considered a risk factor for heart failure and needs more attention in preventive cardiology. [ABSTRACT FROM AUTHOR]

Background: The benefits of exercise for primary and secondary prevention of cardiovascular events have been reported in patients with type 2 diabetes mellitus (T2DM). However, the effects of exercise on cardiac structure and function require clarification. Methods: A literature search for clinical studies reporting on the effects of exercise on cardiac structure, cardiac function, and VO2peak in T2DM patients was conducted. PubMed, Embase, EBSCO, Web of Science, and China National Knowledge Infrastructure were systematically searched for original articles published from January 2000 to July 2023. The effect size was expressed as the mean difference (MD) or standardized mean difference (SMD) and its 95% confidence interval (CI). Subgroup analyses were performed by exercise mode (high-intensity interval training [HIIT] or moderate-intensity continuous training [MICT]) and intervention duration (>6 or ≤6 months). Results: Compared to usual care, both HIIT and MICT significantly affected left ventricular end-diastolic volume (MD: 19.44, 95% CI: 13.72 to 25.17, p < 0.00001; I2 = 42%; MD: 13.90, 95% CI: 7.64 to 20.16, p < 0.0001; I2 = 0%), but only HIIT significantly affected left ventricular mass (MD: 17.04 g, 95% CI: 5.45 to 28.62, p = 0.004; I2 = 0%). HIIT significantly improved left ventricular ejection fraction (MD: 5.52, 95% CI: 2.31 to 8.73, p = 0.0008; I2 = 0%), as did MICT in the ≤6 months subgroup (MD: 1.36, 95% CI: 0.61 to 2.10, p = 0.0004; I2 = 0%). Neither significantly affected systolic tissue velocity. HIIT significantly improved VO2peak (MD: 8.04, 95% CI: 6.26 to 9.83, p < 0.00001; I2 = 0%), as did MICT in the ≤6 months subgroup (MD: 3.33, 95% CI: 2.39 to 4.27, p < 0.00001; I2 = 0%). Conclusion: Exercise significantly improved cardiac structure, systolic function, and VO2peak, but did not significantly affect diastolic function in T2DM patients. HIIT seemed to be superior to MICT at improving VO2peak and left ventricular ejection fraction in T2DM patients. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, PROSPERO registration no.: CRD4242018087376 [ABSTRACT FROM AUTHOR]

Introduction: Initial data suggest that His Bundle Pacing (HBP) could preserve long‐term cardiac structure and function better than Right Ventricular Pacing (RVP), but evidence is limited. Methods: We studied consecutive patients with baseline ejection fraction (EF) ≥ 50% who underwent HBP attempt, either successful (HBP group) or failed (RVP group). Two‐dimensional (2D) and three‐dimensional (3D) echocardiography were carried out at baseline and after 6 months of ventricular pacing burden > 20%. Results: Among 68 patients, 40 underwent successful HBP, and 28 RVP. The HBP and RVP groups did not differ for age, sex and pacing indication. At baseline, the HBP and RVP groups did not differ for 2D EF (62% vs. 62%), 3D EF (60% vs. 63%), 2D (−19% vs. −19%) and 3D global longitudinal strain (GLS) (−15% vs. −16%). After 6 months, 2D EF (−3.86%) and 3D EF (−5.71%) significantly decreased in the RVP group and did not change in the HBP group (p for interaction.006 and <.001, respectively). 2D GLS (3.08%) and 3D GLS (2.22%) significantly increased in the RVP group, but did not change in the HBP group (p for interaction.013 and <.016, respectively). Pacing induced cardiomyopathy (PICM) (EF drop ≥ 10% and EF < 50%) occurred in 14% (RVP) versus 0% (HBP) of patients (p =.025). Conclusions: Successful HBP was superior to RVP in preserving LV systolic function despite a high ventricular pacing burden, and was less frequently associated with PICM. [ABSTRACT FROM AUTHOR]

Abstract Aims Heart failure is known as a health problem in the world due to its mortality and burdens on the health care system. Studies remain controversial about the effect of opium usage on systolic heart function. Therefore, the aim of this study was to compare systolic left ventricular function in opium users with non‐addict people by strain echocardiography and its association with serum apelin level. Methods This case–control study was conducted in 2022 at Shafa Hospital in Kerman, Iran, on 50 opium users who referred to the addiction treatment centres and had no history of other substance usage. The addiction is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) and a history of opium consumption for at least 3 years. Fifty healthy people (non‐opium users) who were matched in terms of age and sex were enrolled as a control group. Demographic information of the participants, including age, gender and amount of opium usage, was recorded by questionnaire. Citrated blood samples were taken from all participants in the study, and serum apelin was measured by the enzyme‐linked immunosorbent assay (ELISA) method. They underwent transthoracic echocardiography by an expert cardiologist using the same device (Philips Affiniti 50). Echocardiographic systolic parameters have been recorded and compared between the two groups. Results In this study, 100 participants, including 50 opium users and 50 non‐opium users (as a control group), were investigated. The mean age was 36.4 ± 5.08 in the opium users' group and 34.14 ± 7.2 in the control group. As both groups were matched, there were 8 (16%) women and 42 (84%) men in each of the two groups. The mean amount of ejection fraction (EF) and global longitudinal strain (GLS) were significantly lower in opium users than in the control group (P

Abstract Background Due to the lack of oestrogen, premature ovarian insufficiency (POI) is an independent risk factor for ischaemic heart disease and overall cardiovascular disease. This study aimed to apply layer-specific myocardial strain for early quantitative evaluation of subclinical left ventricular myocardial systolic function changes in patients with POI. Methods Forty-eight newly diagnosed, untreated patients with POI (POI group) and fifty healthy female subjects matched for age, height and weight (control group) were enrolled. Standard transthoracic echocardiography was used to measure conventional parameters and layer-specific strain parameters.The layer-specific strain parameters included subendomyocardial global longitudinal strain (GLSendo), mid-layer myocardial global longitudinal strain (GLSmid), subepimyocardial global longitudinal strain (GLSepi), subendomyocardial global circumferential strain (GCSendo), mid-layer myocardial global circumferential strain (GCSmid), and subepimyocardial global circumferential strain (GCSepi). Results There were no significant differences in age, body mass index (BMI), blood pressure, or left ventricular ejection fraction (LVEF) between the two groups. The end-diastolic interventricular septal thickness (IVST) was greater in the POI group (8.29 ± 1.32 vs. 7.66 ± 0.82, P = 0.008), and the POI group had lower E, E/A, and lateral e′ (all P

Left atrial fractional shortening (LAFS%) is a widely used index of left atrial systolic function in cats that has been shown to predict development of hypertrophic cardiomyopathy (HCM) and cardiac mortality. It can be determined by two methods: from an M-mode right parasternal short-axis view (LAFS%RPSA-MM) or two-dimensional right parasternal long-axis four-chamber view (LAFS%RPLA-2D). We aimed to assess the agreement between LAFS%RPSA-MM and LAFS%RPLA-2D in cats and to evaluate the correlation between LAFS%RPSA-MM and LAFS%RPLA-2D and left ventricular systolic performance. One hundred and seventeen cats were enrolled in the study: 40 control, 41 HCM stage B (asymptomatic), and 36 HCM stage C (symptomatic) cats. This was a retrospective case–control study. Bland–Altman analysis was used to assess agreement between LAFS%RPSA-MM and LAFS%RPLA-2D across the whole cohort and in cats with asymptomatic and symptomatic HCM. Correlation analysis was used to assess associations between LAFS% methods and forward aortic flow, left ventricular fractional shortening, and aortic root motion. The LAFS% determined by LAFS%RPSA-MM and LAFS%RPLA-2D was similar (P=0.8), but Bland–Altman analysis showed wide limits of agreement between methods. There was a good correlation between LAFS%RPSA-MM and LAFS%RPLA-2D and aortic root motion (r = 0.78 and r = 0.71, respectively) and a fair correlation with left ventricular fractional shortening (r = 0.31 and r = 0.29, respectively). None of the methods showed a correlation with indices of aortic flow. Our study suggests a poor agreement between LAFS%RPSA-MM and LAFS%RPLA-2D, and thus, these methods should not be used interchangeably. Both echocardiographic methods showed good correlation with aortic root motion. [ABSTRACT FROM AUTHOR]

Aims Identifying the imaging method that best predicts all-cause mortality, cardiovascular adverse events, and heart failure risk is crucial for tailoring optimal management. Potential prognostic markers include left ventricular (LV) myocardial mass, ejection fraction, myocardial strain, stroke work, contraction fraction, pressure–strain product, and a new measurement called global longitudinal active strain density (GLASED). This study sought to compare the utility of 23 potential LV prognostic markers of structure and contractile function in a community-based cohort. Methods and results The impact of cardiovascular magnetic resonance image–derived markers extracted by machine learning algorithms was compared with the future risk of adverse events in a group of 44 957 UK Biobank participants. Most markers, including the LV ejection fraction, have limited prognostic value. GLASED was significantly associated with all-cause mortality and major adverse cardiovascular events, with the largest hazard ratio, highest ranking, and differentiated risk in all three tertiles (P ≤ 0.0003). Conclusion GLASED predicted all-cause mortality and major cardiovascular adverse events better than conventional markers of risk and is recommended for assessing patient prognosis. [ABSTRACT FROM AUTHOR]

Introduction: Evidence on myocardial deformation, detected by speckle tracking echocardiography (STE), in patients with acromegaly is scanty. Aim: The aim of the present meta-analysis was to provide an updated information on left ventricular (LV) systolic function assessed by global longitudinal strain (GLS) in patients with acromegaly and preserved LVEF. Methods: Following the PRISMA guidelines, systematic searches were conducted across bibliographic databases (Pub-Med, OVID, EMBASE and Cochrane library) to identify eligible studies from inception up to June 30-2024. Clinical studies published in English reporting data on LV mechanics in patients with acromegaly and controls were included. The statistical difference of the echocardiographic variables of interest between groups such as LVEF and global longitudinal strain (GLS) was calculated by standardized mean difference (SMD) with 95% confidence interval (CI) by using random-effects models. Results: Seven studies including 288 patients with acromegaly and 294 healthy individuals were considered for the analysis. Pooled average LVEF values were 64.6 ± 1.5% in the healthy control group and 64.0 ± 1.3% in the acromegaly group (SMD: − 0.21 ± 0.22, CI -0.62/0.22, p = 0.34); the corresponding values of GLS were − 19.1.1 ± 1.2% and − 17.5 ± 1.2% (SMD: -0.52 ± 0.27, CI − 1.05/0.01, p = 0.05). No difference was found between the two groups for both global circumferential strain (GCS) and global radial strain (GRS). Conclusions: Our findings suggest that patients with acromegaly in which LVEF is completely comparable to healthy controls show an impairment in GLS of borderline statistical significance. Whether GLS assessment can actually unmask early alterations of systolic function in patients with acromegaly better than LVEF will need to be investigated by future studies. [ABSTRACT FROM AUTHOR]

Purpose: Obesity is associated with subclinical impairments in cardiac function. Aerobic exercise has positive effects on cardiac-related parameters. However, different exercise intensities may elicit distinct acute responses, leading to chronic adaptations. Therefore, we aimed to investigate the acute effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on left ventricle (LV) function in women with uncomplicated obesity. Methods: Fifteen women performed a bout of HIIT (4 × 4-min at 85–95% of HRmax), MICT (41-min at 65–75% of HRmax), and control condition (CO) (30-min sitting at rest). Data were collected immediately before, and five (t5) and 35 (t35) minutes after the performance of each condition. Results: Significant decreases in global longitudinal strain (GLS) (p = 0.010; p = 0.002), LV ejection fraction (LVEF) (p = 0.017; p = 0.010), LV end-diastolic volume (LVEDV) (p = 0.001; p = 0.048), stroke volume (SV) (p < 0.001; p = 0.013), early diastolic inflow velocity (E) (p = 0.001; p = 0.003) and E/A ratio (p = 0.001; p < 0.001) were observed for HIIT at t5 in relation to baseline and CO, respectively. However, GLS, LVEF, LVEDV, and E wave were reestablished near baseline values at t35. LV end-systolic volume decreased after HIIT in comparison to baseline at t5 (p = 0.050). GLS and E/A ratio decreased following HIIT at t5 compared to MICT (p = 0.013 and p = 0.027, respectively). Conclusion: A single bout of HIIT promoted transient reductions in LV function that were almost completely reestablished near baseline values 35 min after exercise cessation, not implying, therefore, any risk to HIIT performance by this population. Trial registration number: RBR-3v3dqf (Registered on 07/05/2019). [ABSTRACT FROM AUTHOR]

Background: Due to the lack of oestrogen, premature ovarian insufficiency (POI) is an independent risk factor for ischaemic heart disease and overall cardiovascular disease. This study aimed to apply layer-specific myocardial strain for early quantitative evaluation of subclinical left ventricular myocardial systolic function changes in patients with POI. Methods: Forty-eight newly diagnosed, untreated patients with POI (POI group) and fifty healthy female subjects matched for age, height and weight (control group) were enrolled. Standard transthoracic echocardiography was used to measure conventional parameters and layer-specific strain parameters.The layer-specific strain parameters included subendomyocardial global longitudinal strain (GLSendo), mid-layer myocardial global longitudinal strain (GLSmid), subepimyocardial global longitudinal strain (GLSepi), subendomyocardial global circumferential strain (GCSendo), mid-layer myocardial global circumferential strain (GCSmid), and subepimyocardial global circumferential strain (GCSepi). Results: There were no significant differences in age, body mass index (BMI), blood pressure, or left ventricular ejection fraction (LVEF) between the two groups. The end-diastolic interventricular septal thickness (IVST) was greater in the POI group (8.29 ± 1.32 vs. 7.66 ± 0.82, P = 0.008), and the POI group had lower E, E/A, and lateral e′ (all P < 0.05). As for systolic functions,the POI group had lower GLSendo, GLSmid, GLSepi, GCSendo, GCSmid, and GCSepi (all P < 0.05).The intraobserver and interobserver coefficients of GLSendo, GLSmid, GLSepi, GCSendo, GCSmid, and GCSepi were greater than 0.900. Conclusions: POI patients with normal LVEF may suffer from subclinical left ventricular myocardial systolic dysfunction. Echocardiography of layer-specific myocardial strain could more sensitively detect subclinical impairment of left ventricular systolic function in POI patients. [ABSTRACT FROM AUTHOR]

BackgroundThe benefits of exercise for primary and secondary prevention of cardiovascular events have been reported in patients with type 2 diabetes mellitus (T2DM). However, the effects of exercise on cardiac structure and function require clarification.MethodsA literature search for clinical studies reporting on the effects of exercise on cardiac structure, cardiac function, and VO2peak in T2DM patients was conducted. PubMed, Embase, EBSCO, Web of Science, and China National Knowledge Infrastructure were systematically searched for original articles published from January 2000 to July 2023. The effect size was expressed as the mean difference (MD) or standardized mean difference (SMD) and its 95% confidence interval (CI). Subgroup analyses were performed by exercise mode (high-intensity interval training [HIIT] or moderate-intensity continuous training [MICT]) and intervention duration (>6 or ≤6 months).ResultsCompared to usual care, both HIIT and MICT significantly affected left ventricular end-diastolic volume (MD: 19.44, 95% CI: 13.72 to 25.17, p < 0.00001; I2 = 42%; MD: 13.90, 95% CI: 7.64 to 20.16, p < 0.0001; I2 = 0%), but only HIIT significantly affected left ventricular mass (MD: 17.04 g, 95% CI: 5.45 to 28.62, p = 0.004; I2 = 0%). HIIT significantly improved left ventricular ejection fraction (MD: 5.52, 95% CI: 2.31 to 8.73, p = 0.0008; I2 = 0%), as did MICT in the ≤6 months subgroup (MD: 1.36, 95% CI: 0.61 to 2.10, p = 0.0004; I2 = 0%). Neither significantly affected systolic tissue velocity. HIIT significantly improved VO2peak (MD: 8.04, 95% CI: 6.26 to 9.83, p < 0.00001; I2 = 0%), as did MICT in the ≤6 months subgroup (MD: 3.33, 95% CI: 2.39 to 4.27, p < 0.00001; I2 = 0%).ConclusionExercise significantly improved cardiac structure, systolic function, and VO2peak, but did not significantly affect diastolic function in T2DM patients. HIIT seemed to be superior to MICT at improving VO2peak and left ventricular ejection fraction in T2DM patients.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, PROSPERO registration no.: CRD4242018087376

Abstract Background Global longitudinal active strain energy density (GLASED) is an innovative method for assessing myocardial function and quantifies the work performed per unit volume of the left ventricular myocardium. The GLASED, measured using MRI, is the best prognostic marker currently available. This study aimed to evaluate the feasibility of measuring the GLASED using echocardiography and to investigate potential differences in the GLASED among athletes based on age and sex. Methods An echocardiographic study was conducted with male controls, male and female young athletes, and male and female veteran athletes. GLASED was calculated from the myocardial stress and strain. Results The mean age (in years) of the young athletes was 21.6 for males and 21.4 for females, while the mean age of the veteran athletes was 53.5 for males and 54.2 for females. GLASED was found to be highest in young male athletes (2.40 kJ/m3) and lowest in female veterans (1.96 kJ/m3). Veteran males exhibited lower values (1.96 kJ/m3) than young male athletes did (P

Abstract Some individuals who go to fitness centers for various purposes perform resistance exercise (RE) alone, while others engage in combined exercise (CE) by including cardio exercises along with RE. Studying the effects of these two different training methods on left ventricular (LV) systolic and diastolic parameters and left atrial mechanical function is an important step toward understanding the effects of different types of exercise on cardiac function. This knowledge has significant implications for public health, as it can inform the development of targeted and effective exercise programs that prioritize cardiovascular health and reduce the risk of adverse outcomes. Therefore, the primary aim of this study is to comprehensively investigate the LV systolic and diastolic parameters of athletes who engage in RE and CE using ECHO, to contribute to the growing body of literature on the cardiovascular effects of different types of exercise. Forty-two amateur athletes aged between 17 and 52 were included in our study. The participants consisted of the RE (n = 26) group who did only resistance exercise during the weekly exercise period, and the CE group (n = 16) who also did cardio exercise with resistance exercises. After determining sports age (year), weekly exercise frequency (day), and training volume (min) in addition to demographic information of RE and CE groups, left ventricular systolic and diastolic parameters and left atrial functions were determined by ECHO. Findings from our study revealed that parameters including the left ventricular end-diastolic diameter (LVEDD) (p = .008), left ventricular end-diastolic volume (LVEDV) (p = .020), stroke volume index (SV-I) (p = .048), conduit volume (CV-I) (p = .001), and aortic strain (AS) (p = .017) were notably higher in the RE group compared to the CE group. Also left atrial active emptying volüme (LAAEV) of CE was higher than the RE group (p = .031). In conclusion, the cardiac parameters of the RE group showed more athlete’s heart characteristics than the CE group. These results may help to optimize the cardiovascular benefits of exercise routines while minimizing the potential risks associated with improper training.

Background: Global longitudinal active strain energy density (GLASED) is an innovative method for assessing myocardial function and quantifies the work performed per unit volume of the left ventricular myocardium. The GLASED, measured using MRI, is the best prognostic marker currently available. This study aimed to evaluate the feasibility of measuring the GLASED using echocardiography and to investigate potential differences in the GLASED among athletes based on age and sex. Methods: An echocardiographic study was conducted with male controls, male and female young athletes, and male and female veteran athletes. GLASED was calculated from the myocardial stress and strain. Results: The mean age (in years) of the young athletes was 21.6 for males and 21.4 for females, while the mean age of the veteran athletes was 53.5 for males and 54.2 for females. GLASED was found to be highest in young male athletes (2.40 kJ/m3) and lowest in female veterans (1.96 kJ/m3). Veteran males exhibited lower values (1.96 kJ/m3) than young male athletes did (P < 0.001). Young females demonstrated greater GLASED (2.28 kJ/m3) than did veteran females (P < 0.01). However, no significant difference in the GLASED was observed between male and female veterans. Conclusion: Our findings demonstrated the feasibility of measuring GLASED using echocardiography. GLASED values were greater in young male athletes than in female athletes and decreased with age, suggesting possible physiological differences in their myocardium. The sex-related differences observed in GLASED values among young athletes were no longer present in veteran athletes. We postulate that measuring the GLASED may serve as a useful additional screening tool for cardiac diseases in athletes, particularly for those with borderline phenotypes of hypertrophic and dilated cardiomyopathies. [ABSTRACT FROM AUTHOR]

Introduction: The effects of pre-anesthetic single-dose oral pimobendan during inhalational anesthesia, including the comparison with the effects of single intravenous pimobendan under anesthesia, remain unexplored. Therefore, this study aimed to determine changes in hemodynamic and echocardiographic parameters induced by pre-anesthetic administration of oral pimobendan under isoflurane general anesthesia and to compare them with those induced by intravenous pimobendan. Methods: Thirteen clinically normal dogs (4 laboratory and 9 client-owned dogs) with no clinical signs and not on any medical treatment were included. Anesthesia was performed three times: no pimobendan (Control), oral pimobendan (PIMO PO, 0.3  mg/kg), and intravenous pimobendan (PIMO IV, 0.15  mg/kg). Echocardiographic and hemodynamic parameters were monitored at 30-min intervals in all groups. Results: Compared to the Control group, end-systolic volume index (ESVI) and normalized left ventricular internal diameter at end-systole (LVIDSN) were significantly lower, and fractional shortening (FS) and ejection fraction (EF) were significantly higher in the PIMO PO and IV groups (p <  0.001). Global radial strain (GRS) was significantly higher in the PIMO PO and IV groups (p =  0.015). Conclusion: Under general anesthesia, oral pimobendan preserved LV systolic and myocardial function in a manner comparable to intravenous pimobendan. Pre-anesthetic administration of oral pimobendan can be used to compensate for cardiac systolic function in dogs who require therapeutic and diagnostic procedures under general anesthesia with potential risk of circulatory failure. [ABSTRACT FROM AUTHOR]

Background: Neurocardiogenic injury is common after aneurysmal subarachnoid hemorrhage (aSAH) despite low prevalence of preexisting cardiac disease. Potential mechanisms include autonomic dysregulation due to excess catecholamines as well as systemic inflammation. Understanding how inflammation contributes to cardiac dysfunction may aid in identifying novel therapeutic strategies. Here, we investigated serum leukocytes as predictors of left ventricular systolic dysfunction in patients with aSAH. We also investigated increased cardiac macrophages in an animal model of SAH and whether immunomodulatory treatment could attenuate this inflammatory response. Methods: We retrospectively analyzed 256 patients with aSAH admitted to University of Illinois Hospital between 2013 and 2019. Our inclusion criteria included patients with aSAH receiving an echocardiogram within 72 h of admission. Our primary outcome was echocardiographic evidence of systolic dysfunction. We performed multinomial regression and receiver operating curve analysis. We also used the endovascular perforation model of SAH in male Sprague–Dawley rats to assess for myocardial inflammation. Two days after surgery, hearts were collected and stained for the macrophage marker Iba-1. We compared the presence and morphology of macrophages in cardiac tissue isolated from SAH animals and sham controls treated with and without the immunomodulatory agent fingolimod. Results: Of 256 patients with aSAH, 233 (91.0%) underwent echocardiography within 72 h of admission. Of 233, 81 (34.7%) had systolic dysfunction. Patients had baseline differences in the presence of hypertension, alcohol use, and admission Glasgow Coma Scale and Hunt-Hess score. On multivariable analysis, total leukocytes (odds ratio 1.312, p < 0.001), neutrophils (odds ratio 1.242, p = 0.012), and monocytes (odds ratio 6.112, p = 0.008) were independent predictors of reduced systolic function, whereas only monocytes (odds ratio 28.014, p = 0.030) predicted hyperdynamic function. Within the rodent heart, there were increased macrophages after SAH relative to controls, and this was attenuated by fingolimod treatment (p < 0.0001). Conclusions: Increased serum leukocytes are associated with abnormal left ventricular systolic function following aSAH. The strongest independent predictor of both reduced and hyperdynamic systolic function was increased monocytes. Increased cardiac macrophages after experimental SAH can also be targeted by using immunomodulatory drugs. [ABSTRACT FROM AUTHOR]

Background: In a wide range of clinical settings, comprehensive evaluation of the right ventricle has become increasingly essential. Measures of right ventricle systolic function, including fractional area change, tissue Doppler, S velocity, tricuspid annular plane systolic excursion, show a significant variation in previous studies and different data known regarding how these measurements change with age. Aim of the study: The aim of this study is to evaluate the effects of age on right ventricle systolic function by using conventional 2D echocardiographic assessment. Patients and methods: Comprehensive transthoracic echocardiography examinations were performed on 103 healthy adult volunteers, mean age 37.1±11.9 years (range: 20-66), to determine age related changes in right ventricle dimensions and function. Results: 2DE assessment of right ventricle function demonstrates slightly significant differences in tricuspid annular plane systolic excursion (r= -.197, p = .047), and FAC (r= -.241, p = .015), among age groups, with a nonsignificant very small negative relationship between age and tissue Dopplers (r= -.0925, p = .355). Conclusions: This study has demonstrated that age-adjusted measures are required for the evaluation of right ventricle function. Further, the conventional techniques may ignore mild or slight changes leading to underestimated assessment which regarded as a fundamental challenge for their use; so, the use of advanced techniques which allow early identification of right ventricle dysfunction are recommended since they can detect subclinical dysfunction before anomalies revealed by traditional echocardiography occur. [ABSTRACT FROM AUTHOR]

Some individuals who go to fitness centers for various purposes perform resistance exercise (RE) alone, while others engage in combined exercise (CE) by including cardio exercises along with RE. Studying the effects of these two different training methods on left ventricular (LV) systolic and diastolic parameters and left atrial mechanical function is an important step toward understanding the effects of different types of exercise on cardiac function. This knowledge has significant implications for public health, as it can inform the development of targeted and effective exercise programs that prioritize cardiovascular health and reduce the risk of adverse outcomes. Therefore, the primary aim of this study is to comprehensively investigate the LV systolic and diastolic parameters of athletes who engage in RE and CE using ECHO, to contribute to the growing body of literature on the cardiovascular effects of different types of exercise. Forty-two amateur athletes aged between 17 and 52 were included in our study. The participants consisted of the RE (n = 26) group who did only resistance exercise during the weekly exercise period, and the CE group (n = 16) who also did cardio exercise with resistance exercises. After determining sports age (year), weekly exercise frequency (day), and training volume (min) in addition to demographic information of RE and CE groups, left ventricular systolic and diastolic parameters and left atrial functions were determined by ECHO. Findings from our study revealed that parameters including the left ventricular end-diastolic diameter (LVEDD) (p =.008), left ventricular end-diastolic volume (LVEDV) (p =.020), stroke volume index (SV-I) (p =.048), conduit volume (CV-I) (p =.001), and aortic strain (AS) (p =.017) were notably higher in the RE group compared to the CE group. Also left atrial active emptying volüme (LAAEV) of CE was higher than the RE group (p =.031). In conclusion, the cardiac parameters of the RE group showed more athlete's heart characteristics than the CE group. These results may help to optimize the cardiovascular benefits of exercise routines while minimizing the potential risks associated with improper training. [ABSTRACT FROM AUTHOR]

Introduction: Malnutrition during a critical window of development in a fetus or infant can result in abnormal cardiac remodeling and function. It is uncertain whether the contribution of these effects continues to impact the cardiac remodeling and function of adults over the course of several decades of growth. Our study examined the impact of early Chinese famine exposure on cardiac remodeling, left ventricular (LV) diastolic function, and LV systolic function in adults. Methods: Participants at high risk of cardiovascular disease from the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project (PEACE MPP) were enrolled. The famine in China lasted from 1959 to 1962. A total of three groups were formed based on the participants' birth dates: pre-famine group, famine exposure group, and post-famine group. Logistic regression and linear mixed models were used to explore the association between famine exposure and cardiac remodeling, LV diastolic function and LV systolic function in adults. Results: The study included 2,758 participants, the mean age was 57.05 years, 62.8% were female, 26.4% had LV hypertrophy (LVH), 59.6% had LV diastolic dysfunction (LVDD), and 10.5% had reduced global longitudinal strain (GLS). Compared to post-famine exposure, participants had independently increased risk of LVH in the famine exposure group (OR: 2.02, 95% CI: 1.60–2.56) and pre-famine exposure (OR: 1.36, 95% CI: 1.06–1.76). Compared to post-famine exposure, the risk of LVDD remarkably increased in the famine exposure group (OR: 3.04, 95% CI: 2.49–3.71) and pre-famine exposure group (OR: 1.87, 95% CI: 1.52–2.31). Famine exposure had no significant impact on GLS but was associated with a significant increase in LV ejection fraction (LVEF) and LV end-diastolic diameter (LVEDD). Significant interactions were observed between the effects of famine exposure and other clinical/sociodemographic variables (gender, systolic blood pressure [SBP] ≥140 mm Hg or not, high school or above or not, and annual income <50,000 RMB or not) on these outcomes. Conclusion: Exposure to famine, particularly during fetal and infant stages, increases the risk of LVH and LVDD in adults. However, the LV systolic function remains preserved. These impacts are more pronounced in females, individuals with SBP ≥140 mm Hg, those with low income, or those with high educational status. [ABSTRACT FROM AUTHOR]

Aims Echocardiography is a cornerstone in cardiac imaging, and left ventricular (LV) ejection fraction (EF) is a key parameter for patient management. Recent advances in artificial intelligence (AI) have enabled fully automatic measurements of LV volumes and EF both during scanning and in stored recordings. The aim of this study was to evaluate the impact of implementing AI measurements on acquisition and processing time and test–retest reproducibility compared with standard clinical workflow, as well as to study the agreement with reference in large internal and external databases. Methods and results Fully automatic measurements of LV volumes and EF by a novel AI software were compared with manual measurements in the following clinical scenarios: (i) in real time use during scanning of 50 consecutive patients, (ii) in 40 subjects with repeated echocardiographic examinations and manual measurements by 4 readers, and (iii) in large internal and external research databases of 1881 and 849 subjects, respectively. Real-time AI measurements significantly reduced the total acquisition and processing time by 77% (median 5.3 min, P < 0.001) compared with standard clinical workflow. Test–retest reproducibility of AI measurements was superior in inter-observer scenarios and non-inferior in intra-observer scenarios. AI measurements showed good agreement with reference measurements both in real time and in large research databases. Conclusion The software reduced the time taken to perform and volumetrically analyse routine echocardiograms without a decrease in accuracy compared with experts. [ABSTRACT FROM AUTHOR]

Background: In a wide range of clinical settings, comprehensive evaluation of the right ventricle has become increasingly essential. Measures of right ventricle systolic function, including fractional area change, tissue Doppler, S velocity, tricuspid annular plane systolic excursion, show a significant variation in previous studies and different data known regarding how these measurements change with age. Aim of the study: The aim of this study is to evaluate the effects of age on right ventricle systolic function by using conventional 2D echocardiographic assessment. Patients and methods: Comprehensive transthoracic echocardiography examinations were performed on 103 healthy adult volunteers, mean age 37.1±11.9 years (range: 20-66), to determine age related changes in right ventricle dimensions and function. Results: The assessment of right ventricle function demonstrates slightly significant differences in tricuspid annular plane systolic excursion (r= -.197, p = .047), and FAC (r= -.241, p = .015), among age groups, with a non-significant very small negative relationship between age and tissue Dopplers (r= -.0925, p = .355). Conclusions: This study has demonstrated that age-adjusted measures are required for the evaluation of right ventricle function. Further, the conventional techniques may ignore mild or slight changes leading to underestimated assessment which regarded as a fundamental challenge for their use; so, the use of advanced techniques which allow early identification of right ventricle dysfunction are recommended since they can detect subclinical dysfunction before anomalies revealed by traditional echocardiography occur.

Abstract Background Left ventricular ejection fraction (LVEF) is inconsistently associated with poor outcomes in patients with sepsis. Newer parameters such as LV longitudinal strain (LVLS), mitral annular plane systolic excursion (MAPSE) and LV longitudinal wall fractional shortening (LV-LWFS) may be more sensitive indicators of LV dysfunction, but are sparsely investigated. Our objective was to evaluate the association between five traditional and novel echocardiographic parameters of LV systolic function (LVEF, peak tissue Doppler velocity at the mitral valve (s´), LVLS, MAPSE and LV-LWFS) and outcomes in patients admitted to the Intensive Care Unit (ICU) with septic shock. Methods A total of 152 patients admitted to the ICU with septic shock from two data repositories were included. Transthoracic echocardiograms were performed within 24 h of ICU admission. The primary outcome was myocardial injury, defined as high-sensitivity troponin T ≥ 45 ng/L on ICU admission. Secondary outcomes were organ support-free days (OSFD) and 30-day mortality. We also tested for the prognostic value of the systolic function parameters using multivariable analysis. Results LVLS, MAPSE and LV-LWFS, but not LVEF and s´, differed between patients with and without myocardial injury. After adjustment for age, pre-existing cardiac disease, Simplified Acute Physiology (SAPS3) score, Sequential Organ Failure Assessment (SOFA) score, plasma creatinine and presence of right ventricular dysfunction, only MAPSE and LV-LWFS were independently associated with myocardial injury. None of the systolic function parameters were associated with OSFD or 30-day mortality. Conclusions MAPSE and LV-LWFS are independently associated with myocardial injury and outperform LVEF, s´ and LVLS. Whether these parameters are associated with clinical outcomes such as the need for organ support and short-term mortality is still unclear. Trial registration NCT01747187 and NCT04695119.

Abstract Background Impairment of left ventricular (LV) longitudinal function is an early marker of systolic dysfunction in hypertrophic cardiomyopathy (HCM). Aortic annular plane systolic excursion (AAPSE) is a measure of LV longitudinal function in people that has not been evaluated in cats. Hypothesis Aortic annular plane systolic excursion is lower in cats with HCM compared to control cats, and cats in stage C have the lowest AAPSE. Animals One hundred seventy‐five cats: 60 normal, 61 HCM stage B and 54 HCM stage C cats. Materials Multicenter retrospective case‐control study. Electronic medical records from 4 referral hospitals were reviewed for cats diagnosed with HCM and normal cats. HCM was defined as LV wall thickness ≥6 mm and normal cats ≤5 mm. M‐mode bisecting the aorta in right parasternal short‐axis view was used to measure AAPSE. Results Aortic annular plane systolic excursion was lower in HCM cats compared to normal cats (3.9 ± 0.9 mm versus 4.6 ± 0.9 mm, P

Background: Measuring left ventricular ejection fraction (LVEF) is important for detecting heart failure, e.g., in treatment with potentially cardiotoxic chemotherapy. MRI is considered the reference standard for LVEF, but availability may be limited and claustrophobia or metal implants still present challenges. CT has been shown to be accurate and would be advantageous, as LVEF could be measured in conjunction with routine chest–abdomen–pelvis oncology CT. However, the use of CT is not recommended due to the excessive radiation dose. This study aimed to explore the potential for dose reduction using simulation. Using an anthropomorphic heart phantom scanned at 13 dose levels, a noise simulation algorithm was developed to introduce controlled Poisson noise. Filtered backprojection parameters were iteratively tested to minimise differences in myocardium-to-ventricle contrast/noise ratio, as well as structural similarity index (SSIM) differences between real and simulated images at all dose levels. Fifty-one clinical CT coronary angiographies, scanned with full dose through end-systolic and -diastolic phases, were located retrospectively. Using the developed algorithm, noise was introduced corresponding to 25, 10, 5 and 2% of the original dose level. LVEF was measured using clinical software (Syngo.via VB50) with papillary muscles in and excluded from the LV volume. At each dose level, LVEF was compared to the 100% dose level, using Bland–Altman analysis. The effective dose was calculated from DLP using a conversion factor of 0.026 mSv/mGycm. Results: In the clinical images, mean CTDIvol and DLP were 47.1 mGy and 771.9 mGycm, respectively (effective dose 20.0 mSv). Measurements with papillary muscles excluded did not exhibit statistically significant LVEF bias to full-dose images at 25, 10 and 5% simulated dose. At 2% dose, a significant bias of 4.4% was found. With papillary muscles included, small but significant biases were found at all simulated dose levels. Conclusion: Provided that measurements are performed with papillary muscles excluded from the LV volume, the dose can be reduced by a factor of 20 without significantly affecting LVEF measurements. This corresponds to an effective dose of 1 mSv. CT can potentially be used for LVEF measurement with minimal excessive radiation.

Aim. To outline echocardiographic features and assess their prognostic significance for major cardiovascular adverse events (MACEs) within 12 months in patients with type 2 myocardial infarction (MI), compared to type 1 MI (T1MI).Material and methods. The prospective observational study included 161 MI patients who underwent coronary angiography within 24 hours of admission. Type 2 MI (T2MI) diagnosis aligned with the Fourth Universal Definition. Echocardiography and speckle-tracking echocardiography were performed within 72 hours of hospitalization. MACEs encompassed cardiovascular death, non-fatal MI, non-fatal stroke, and HF-related readmissions. Logistic regression analysis was conducted to evaluate their associations with the outcomes.Results. T2MI were diagnosed in 74 patients (median age, 65 years; males, 55,4%). During follow up, 18 patients for each MI type experienced at least one MACE event. Left ventricular (LV) systolic dysfunction (LV ejection fraction [LVEF]

Diabetes mellitus is a prevalent risk factor for congestive heart failure. Diabetic cardiomyopathy patients present with left ventricular (LV) diastolic dysfunction at an early stage, then systolic dysfunction as the disease progresses. The mechanism underlying the development of diabetic cardiomyopathy has not yet been fully understood. This study aimed to elucidate the mechanisms by which diastolic dysfunction precedes systolic dysfunction at the early stage of diabetic cardiomyopathy. We hypothesized that the downregulation of cardioprotective factors is involved in the pathogenesis of diabetic cardiomyopathy. LV diastolic dysfunction, but not systolic dysfunction, was observed in type-1 diabetes mellitus model mice 4 weeks after STZ administration (STZ-4W), mimicking the early stage of diabetic cardiomyopathy. Counter to expectations, neuregulin-1 (NRG1) was markedly upregulated in the vascular endothelial cell in the ventricles of STZ-4W mice. To clarify the functional significance of the upregulated NRG1, we blocked its receptor ErbB2 with trastuzumab (TRZ). In STZ-4W mice, TRZ significantly reduced the systolic function without affecting diastolic function and caused a more prominent reduction in Akt phosphorylation levels. These results indicate that the compensatory upregulated NRG1 contributes to maintaining the LV systolic function, which explains why diastolic dysfunction precedes systolic dysfunction at the early stage of diabetic cardiomyopathy.

BackgroundAlthough left ventricular (LV) diastolic dysfunction is more related to functional capacity after acute myocardial infarction (AMI), the determinants of LV diastolic functional change after reperfused AMI remain unknown. This study aimed to investigate the effects of microvascular obstruction (MVO) on mid-term changes in LV diastolic function after reperfused AMI.MethodsIn a cohort of 72 AMI patients who underwent successful revascularization, echocardiography and cardiovascular magnetic resonance imaging were repeated at 9-month intervals. The late gadolinium enhancement (LGE) amount, segmental extracellular volume fraction, global LV, and left atrial (LA) phasic functions, along with mitral inflow and tissue Doppler measurements, were repeated.ResultsAmong the included patients, 31 (43%) patients had MVO. During the 9-month interval, LV ejection fraction (EF) and LV global longitudinal strain (GLS) were significantly improved in accordance with a decrease in LGE amount (from 18.2 to 10.3 g, p

Cardiac dysfunction frequently emerges in the initial stages of cancer cachexia, posing a significant complication of the disease. Physical fitness is commonly recommended in these early stages of cancer cachexia due to its beneficial impacts on various aspects of the condition, including cardiac dysfunction. However, the direct functional impacts of exercise on the heart during cancer cachexia largely remain unexplored. In this study, we induced cancer cachexia in mice using a metastatic B16F10 melanoma model. Concurrently, these mice underwent a low-intensity exercise regimen to investigate its potential role in cardiac function during cachexia. Our findings indicate that exercise training can help prevent metastatic melanoma-induced muscle loss without significant alterations to body and fat weight. Moreover, exercise improved the melanoma-induced decline in left ventricular ejection fraction and fractional shortening, while also mitigating the increase in high-sensitive cardiac troponin T levels caused by metastatic melanoma in mice. Transcriptome analysis revealed that exercise significantly reversed the transcriptional alterations in the heart induced by melanoma, which were primarily enriched in pathways related to heart contraction. These results suggest that exercise can improve systolic heart function and directly influence the transcriptome of the heart during metastatic melanoma-induced cachexia.

Background: Obesity is one of the major risk factors for the development of heart failure (HF), although the exact underlying mechanism remains unclear. In the clinical setting, assessing the impact of obesity on the cardiovascular system is difficult due to comorbidities. Objectives: The purpose of this study was to evaluate an independent influence of obesity on the left ventricular (LV) morphology and function. To eliminate hemodynamic and metabolic confounders, we performed an echocardiographic evaluation of severely obese but normotensive and metabolically healthy patients without fatty liver disease. Methods: The patients were retrospectively selected from the cohort of 180 consecutive obese patients systematically evaluated with transthoracic echocardiography before bariatric surgery. Finally, 25 obese subjects, predominantly females, were evaluated with transthoracic echocardiography. Inclusion criteria were defined as absence of diabetes, hypertension, and hyperlipidemia, no use of medications and no hepatic steatosis on liver biopsy. They were matched with a control group of healthy subjects with normal body mass index. Results: In obese patients, LV hypertrophy (LVH) (expressed as LV mass indexed for height in meters2.7) was significantly more frequent in the obese group (48 vs. 0%, p < 0.001). LV longitudinal systolic function measured by mitral annular systolic velocity was significantly lower in the obese group (S' 8.5 vs. 9.7 cm/s, p = 0.002). All studied indices of the LV diastolic function (E/A, mean E' and E/E' ratio) were impaired in obese subjects, even after adjustment for systolic blood pressure and heart rate (E/A 1.31 vs. 1.64, p < 0.001, E' mean 11 vs. 14.8 cm/s, p < 0.001, E/E' 7.5 vs. 6.4, p = 0.002 for obese vs. controls, respectively). Conclusions: LVH is significantly more common, and LV diastolic and longitudinal systolic function is significantly impaired in young, metabolically healthy, normotensive, severely obese individuals without fatty liver disease when compared to age and sex-matched lean subjects. These abnormalities may represent the independent effect of the obesity on the heart, which may contribute to the development the obesity-related HF in later life. [ABSTRACT FROM AUTHOR]

Background: Impairment of left ventricular (LV) longitudinal function is an early marker of systolic dysfunction in hypertrophic cardiomyopathy (HCM). Aortic annular plane systolic excursion (AAPSE) is a measure of LV longitudinal function in people that has not been evaluated in cats. Hypothesis: Aortic annular plane systolic excursion is lower in cats with HCM compared to control cats, and cats in stage C have the lowest AAPSE. Animals: One hundred seventy‐five cats: 60 normal, 61 HCM stage B and 54 HCM stage C cats. Materials: Multicenter retrospective case‐control study. Electronic medical records from 4 referral hospitals were reviewed for cats diagnosed with HCM and normal cats. HCM was defined as LV wall thickness ≥6 mm and normal cats ≤5 mm. M‐mode bisecting the aorta in right parasternal short‐axis view was used to measure AAPSE. Results: Aortic annular plane systolic excursion was lower in HCM cats compared to normal cats (3.9 ± 0.9 mm versus 4.6 ± 0.9 mm, P <.001) and was lowest in HCM stage C (2.4 ± 0.6 mm, P <.001). An AAPSE <2.9 mm gave a sensitivity of 83% (95% CI 71%‐91%) and specificity of 92% (95% CI 82%‐97%) to differentiate HCM stage C from stage B. AAPSE correlated with mitral annular plane systolic excursion (r =.6 [.4‐.7], P <.001), and atrial fractional shortening (r =.6 [.5‐.7], P <.001), but showed no correlation with LV fractional shortening. Conclusions and Clinical Importance: Aortic annular plane systolic excursion is an easily acquired echocardiographic variable and might be a new measurement of LV systolic performance in cats with HCM. [ABSTRACT FROM AUTHOR]

Aims To assess the additional prognostic significance of echocardiographic parameters of subpulmonary left ventricular (LV) size and function in patients with a systemic right ventricle (SRV). Methods and results All adults with an SRV who underwent transthoracic echocardiography in 2010–18 at a large tertiary centre were identified. Biventricular size and function were assessed at the most recent examination. The study endpoint was all-cause mortality or heart/heart–lung transplantation. We included 180 patients, with 100 (55.6%) males, with a mean age of 42.4 ± 12.3 years, of whom 103 (57.2%) had undergone Mustard/Senning operations and 77 (42.8%) had congenitally corrected transposition of great arteries. Over 4.9 (3.8–5.7) years, 28 (15.6%) patients died and 4 (2.2%) underwent heart or heart–lung transplantation. Univariable predictors of the study endpoint included age, New York Heart Association functional Class III or IV, history of atrial arrhythmias, presence of a pacemaker or cardioverter defibrillator, high B-type natriuretic peptide, and echocardiographic markers of SRV and subpulmonary LV size and function. On multivariable Cox analysis of echocardiographic variables, indexed LV end-systolic diameter [ESDi; hazard ratio (HR) 2.77 (95% confidence interval, CI) 1.35–5.68, P = 0.01], LV fractional area change [FAC; HR 0.7 (95% CI 0.57–0.85), P = 0.002), SRV basal diameter [HR 1.66 (95% CI 1.21–2.29), P = 0.005], and SRV FAC [HR 0.65 (95% CI 0.49–0.87), P = 0.008] remained predictive of mortality or transplantation. On receiver-operating characteristic analysis, subpulmonary LV parameters performed better than SRV markers in predicting adverse events. Conclusion SRV basal diameter, SRV FAC, LV ESDi, and LV FAC are significantly and independently associated with mortality and transplantation in adults with an SRV. Accurate echocardiographic assessment of both SRV and subpulmonary LV is, therefore, essential to inform risk stratification and management. [ABSTRACT FROM AUTHOR]

Dobutamine effects on the relationships of the peak velocity of left ventricular (LV) long-axis systolic motion (s′) with systolic excursion (SExc), systolic duration (SDur) and heart rate, of LV long-axis early diastolic excursion (EDExc) with SExc, and of the peak velocity of LV long-axis early diastolic motion (e′) with EDExc, early diastolic duration (EDDur) and isovolumic relaxation time (IVRT') are unknown. Two groups of adult subjects, one young and healthy (n = 10), and one with impaired LV long-axis function (n = 10), were studied, with the aim of identifying consistent findings for the two groups and for the septal and lateral walls. Dobutamine was infused at doses of 5 and 10 µg/kg/min. The relationships between tissue Doppler imaging (TDI) variables acquired before and during dobutamine infusion were analysed using mixed effect multivariate regression modelling. In both groups, heart rate increased and SDur decreased during dobutamine infusion, and there were independent inverse correlations of SDur with heart rate and dobutamine dose. In contrast, there was no change in EDDur during dobutamine infusion, and no consistent changes in IVRT' independent of heart rate. s′ was positively correlated with SExc and inversely correlated with SDur, and there were positive correlations between EDExc and SExc and between e′ and EDExc. Dobutamine increases s′ due to effects on both systolic excursion and duration and it increases e′ due to the associated increases in systolic and early diastolic excursion. A lack of effect on diastolic times does not support the presence of a lusitropic effect of dobutamine. [ABSTRACT FROM AUTHOR]

Background: Measuring left ventricular ejection fraction (LVEF) is important for detecting heart failure, e.g., in treatment with potentially cardiotoxic chemotherapy. MRI is considered the reference standard for LVEF, but availability may be limited and claustrophobia or metal implants still present challenges. CT has been shown to be accurate and would be advantageous, as LVEF could be measured in conjunction with routine chest–abdomen–pelvis oncology CT. However, the use of CT is not recommended due to the excessive radiation dose. This study aimed to explore the potential for dose reduction using simulation. Using an anthropomorphic heart phantom scanned at 13 dose levels, a noise simulation algorithm was developed to introduce controlled Poisson noise. Filtered backprojection parameters were iteratively tested to minimise differences in myocardium-to-ventricle contrast/noise ratio, as well as structural similarity index (SSIM) differences between real and simulated images at all dose levels. Fifty-one clinical CT coronary angiographies, scanned with full dose through end-systolic and -diastolic phases, were located retrospectively. Using the developed algorithm, noise was introduced corresponding to 25, 10, 5 and 2% of the original dose level. LVEF was measured using clinical software (Syngo.via VB50) with papillary muscles in and excluded from the LV volume. At each dose level, LVEF was compared to the 100% dose level, using Bland–Altman analysis. The effective dose was calculated from DLP using a conversion factor of 0.026 mSv/mGycm. Results: In the clinical images, mean CTDIvol and DLP were 47.1 mGy and 771.9 mGycm, respectively (effective dose 20.0 mSv). Measurements with papillary muscles excluded did not exhibit statistically significant LVEF bias to full-dose images at 25, 10 and 5% simulated dose. At 2% dose, a significant bias of 4.4% was found. With papillary muscles included, small but significant biases were found at all simulated dose levels. Conclusion: Provided that measurements are performed with papillary muscles excluded from the LV volume, the dose can be reduced by a factor of 20 without significantly affecting LVEF measurements. This corresponds to an effective dose of 1 mSv. CT can potentially be used for LVEF measurement with minimal excessive radiation. [ABSTRACT FROM AUTHOR]

Objective: Left ventricular and left atrial strain are sensitive and reliable markers for evaluating cardiac function in patients with type 2 diabetes mellitus (T2DM), with interactions between the two parameters. The present study aimed to analyze the correlation between global longitudinal strain (GLS) of the left ventricle and glycated hemoglobin (HbA1c) levels in patients with T2DM. Methods: A total of 292 patients clinically diagnosed with T2DM were selected and divided into three groups according to HbA1c level. The strains of the left atrium and left ventricle in the three groups of T2DM patients with different HbA1c levels were compared. Univariate and multivariate (including left atrial functional indicators) linear regression analyses were performed to assess the relationship between strain indicators and HbA1c levels. Generalized additive models were used to examine the relationship between strain indicators and HbA1c levels. Results: There were significant differences among the three groups in terms of age, microalbuminuria, total cholesterol, fasting blood glucose, postprandial blood glucose, and HbA1c level, and left atrial conduit longitudinal strain (LAScd) and GLS (p <.05). Univariate and multivariate linear regression analyses revealed that, as HbA1c levels increased, the absolute value of GLS gradually decreased (p <.001). Curve fitting revealed a positive correlation between HbA1c level and GLS, which was not affected by left atrial function. Conclusion: Left ventricular GLS was independently correlated with HbA1c level in patients with T2DM and was not affected by left atrial function. [ABSTRACT FROM AUTHOR]

Background: Despite growing evidence linking Vitamin D (Vit-D) deficiency with heart dysfunction, objective evidence such as echocardiographic findings remains limited and inconclusive. Objectives: This study aims to investigate the association between Vit-D levels and both systolic and diastolic function of the ventricles in patients with normal coronary arteries using echocardiography. Methods: This study, conducted between 2019 and 2020, examined individuals without apparent coronary artery disease (CAD). The researchers measured the participants' Vit-D levels and divided them into two groups based on a 30 ng/dL cut-off point. All patients underwent echocardiography, and the researchers analyzed and compared their ventricular systolic function characteristics. Results: A total of 27 patients with normal Vit-D levels and 47 patients with Vit-D deficiency were included in the study. There was no significant difference between the left ventricle (LV) and right ventricle (RV) systolic function parameters, including left ventricular ejection fraction (LVEF), LV end-systolic/diastolic volume, and tricuspid annular plane systolic excursion. The mean LVEF between the patients with normal Vit-D levels (53%) and those with Vit-D deficiency (57%) did not show a significant difference (P = 0.420). Right ventricle diastolic parameters, such as A, E, E', deceleration time (DT), and Right Atrial Volume Index (RAVi), also did not show a significant difference between the two groups. However, patients with Vit-D deficiency had higher diastolic blood pressure (DBP) (P = 0.019). Conclusions: The results of this study indicate that there is no significant correlation between Vit-D levels and systolic dysfunction in the right and LV s of individuals with normal coronary arteries. However, it is important to note that this is a complex area of study, and further research is needed. [ABSTRACT FROM AUTHOR]

Background. The prevalence of chronic heart failure in the world is increasing; however, it is stabilizing in developed countries. One of the reasons for this stabilization is an improvement of acute coronary syndrome treatment and revascularization. Revascularization in patients with chronic coronary syndromes without signs of the left ventricular dysfunction is less effective. One of the promising methods for assessing left ventricular dysfunction is the detection of electrical and mechanical dyssynchrony of the myocardium (DM). However, mechanical dyssynchrony of the myocardium has not been sufficiently studied in patients with coronary artery (CA) disease. The purpose was to assess the relationship between mechanical myocardial dyssynchrony and the degree of coronary artery occlusion in patients with coronary artery disease who underwent revascularization. Materials and methods. One hundred and thirty-four patients with coronary artery disease (35 with myocardial infarction and 99 with chronic coronary syndromes) who underwent coronary angiography and revascularization of coronary arteries were included in the study. According to the results of coronary angiography, patients were divided into 3 groups: 12 had unchanged CA (group 1), 17 had atherosclerotic lesions of CA without signs of occlusion (group 2), and 105 patients were with CA occlusion. Among those with CA occlusion, 10 people had an occlusion of less than 50 %, 26 patients had occlusion from 50 to 80 %, 36 had more than 80 %, and 33 patients had complete occlusion of at least one coronary artery. In all patients, parameters of mechanical DM were determined by ultrasound method. Results. In the first group, 3 patients (25 %) had mechanical DM, in the second — 4 patients (23.5 %), in the group with coronary artery occlusion, 42 patients (40 %) had mechanical DM. In the group with complete CA occlusion, mechanical DM was detected in 18 (53 %) cases. Septal to posterior wall motion delay (SPWMD) did not differ significantly in the comparison groups; however, it increased significantly to 64.8 ± 43.2 ms in patients with complete CA occlusion compared with 40.8 ± 13.1 ms in the group with unchanged CA (p < 0.05). SPWMD had a significant correlation with the degree of CA occlusion (r = 0.254, p = 0.009). The interventricular mechanical delay increased significantly, to 61.3 ± 40.5 ms compared with 33.4 ± 3.4 ms in patients with unchanged CA (p

Traditionally, congestive heart failure (HF) was phenotyped by echocardiography or other imaging techniques according to left ventricular (LV) ejection fraction (LVEF). The more recent echocardiographic modality speckle tracking strain is complementary to LVEF, as it is more sensitive to diagnose mild systolic dysfunction. Furthermore, when LV systolic dysfunction is associated with a small, hypertrophic ventricle, EF is often normal or supernormal, whereas LV global longitudinal strain can reveal reduced contractility. In addition, segmental strain patterns may be used to identify specific cardiomyopathies, which in some cases can be treated with patient-specific medicine. In HF with preserved EF (HFpEF), a diagnostic hallmark is elevated LV filling pressure, which can be diagnosed with good accuracy by applying a set of echocardiographic parameters. Patients with HFpEF often have normal filling pressure at rest, and a non-invasive or invasive diastolic stress test may be used to identify abnormal elevation of filling pressure during exercise. The novel parameter LV work index, which incorporates afterload, is a promising tool for quantification of LV contractile function and efficiency. Another novel modality is shear wave imaging for diagnosing stiff ventricles, but clinical utility remains to be determined. In conclusion, echocardiographic imaging of cardiac function should include LV strain as a supplementary method to LVEF. Echocardiographic parameters can identify elevated LV filling pressure with good accuracy and may be applied in the diagnostic workup of patients suspected of HFpEF. [ABSTRACT FROM AUTHOR]

We derived reference values of left-ventricular (LV) and right-ventricular (RV) strain parameters in a cohort of 100 healthy subjects by feature tracking cardiac magnetic resonance (FT-CMR). Global and regional strain values were calculated for the LV; circumferential and radialSAX strain parameters were derived from the short-axis (SAX) stack, while longitudinal and radialLAX strain parameters were assessed in three long-axis (LAX) views. Only global longitudinal strain (GLS) was calculated for the RV. Peak global LV circumferential strain was −16.7% ± 2.1%, LV radialSAX strain was 26.4% ± 5.1%, LV radialLAX strain was 31.1% ± 5.2%, LV GLS was −17.7% ± 1.9%, and RV GLS was −23.9% ± 4.1%. Women presented higher global LV and RV strain values than men; all strain values presented a weak relationship with body surface area, while there was no association with age or heart rate. A significant association was detected between all LV global strain measures and LV ejection fraction, while RV GLS was correlated to RV end-diastolic volume. The intra- and inter-operator reproducibility was good for all global strain measures. In the regional analysis, circumferential and radial strain values resulted higher at the apical level, while longitudinal strain values were higher at the basal level. The assessment of cardiac deformation by FT-CMR is feasible and reproducible and gender-specific reference values should be used. [ABSTRACT FROM AUTHOR]

Abstract Background There has been a recent association between nontraditional diets and development of diet‐associated dilated cardiomyopathy (DCM) in dogs. Hypothesis/Objectives To compare echocardiographic measurements and cardiac biomarkers between healthy dogs eating nontraditional vs traditional diets. We hypothesized that dogs eating nontraditional diets would have lower measures of systolic myocardial performance compared to dogs eating traditional diets. Animals Forty‐six healthy dogs: 23 eating nontraditional diets and 23 eating traditional diets. Methods Prospective, cross‐sectional study. Dogs were divided into groups based on diet ingredients. Dogs underwent 2‐dimensional (2D), 3‐dimensional (3D), and Doppler echocardiographic examinations and analysis of plasma N‐terminal prohormone of B‐type natriuretic peptide, serum cardiac troponin I, and whole blood and plasma taurine concentrations. Results Mean 2D ejection fraction (EF) was lower for dogs eating nontraditional diets (48.65 ± 7.42%) vs dogs eating traditional diets (56.65 ± 4.63%; P

The evaluation of left ventricular (LV) systolic function is an essential part of the clinical practice of cardiology. Although left ventricular ejection fraction (LVEF) is the most validated and widely used parameter, it has fundamental limitations. LV strain is more sensitive to detect subtle myocardial dysfunction when LVEF was preserved, but it is load-dependent. Invasive left ventricular pressure-volume loop (LV-PVL) is the reliable standard to evaluate cardiac function, but its wide clinical application is limited by the risk of invasive LV pressure detection. Until the advent of non-invasive LV pressure-strain loop (LV-PSL), things have changed. LV-PSL is in good agreement with regional myocardial oxygen consumption and metabolism. Compared with traditional echocardiographic parameters or LV strain, myocardial work (MW) derived from LV-PSL is a more advanced tool that combines deformation as well as hemodynamics through integration of global longitudinal strain and non-invasive LV systolic pressure. In recent years, researches on MW are going on in full swing and show many advantages of MW. This review described the method and discussed the applications, advantages, limitations, and prospects of MW in multiple cardiovascular diseases. The goal is to provide the readers new insights for evaluating LV systolic function and promote the incorporation of MW into daily practice.

The 2019 novel coronavirus disease (COVID-19) has been reported as pandemy and the number of patients continues to rise. Based on recent data, cardiac injury is a prominent feature of the disease, leading to increased morbidity and mortality. In the present study we aimed to evaluate myocardial dysfunction using transthoracic echocardiography (TTE) and tissue Doppler imaging (TDI) in hospitalized COVID-19 patients. We recruited 30 patients (56.7% male, 55.80 ± 14.949 years) who were hospitalized with the diagnosis COVID-19 infection. We analyzed left ventricular (LV) and right ventricular (RV) conventional and TDI parameters at the time of hospitalization and during the course of the disease. Patients without any cardiac disease and with preserved LV ejection fraction (EF) were included. TTE examination was performed and all the variables were recorded and analyzed retrospectively. We observed that both LV and RV conventional echocardiographic parameters were similar when the day of admission to the hospital was compared to the 5th day of the disease. Regarding TDI analysis, we demonstrated significant impairment in LV septal and lateral deformation (P < 0.001). In the correlation analysis no marked correlation was observed between impairment in LV deformation and inflammation biomarkers. Cardiac involvement is an important feature of the COVID-19 infection but the exact mechanism is still undefined. Echocardiography is an essential technique to describe myocardial injury and provide new concepts for the possible definitions of cardiac dysfunction. [ABSTRACT FROM AUTHOR]