This prospective cohort study was conducted on fifty patients presented with STEMI and underwent primary PCI to Assess the impact of primary percutaneous coronary intervention (Primary PCI) on the left ventricular (LV) systolic function in patients with Acute STEMI using speckle tracking Echocardiography within the first 24 hrs and within 1 month after performing PCI. All patients were evaluated by history taking, clinical examination, laboratory investigations and coronary angiography assessment with revascularization of the infarct-related artery (IRA). All patients had CCU admission for 3 days. Conventional 2D echocardiography was performed within 24 h of Primary PCI to assess LV Global longitudinal peak systolic strain (GLPSS). All patients had been discharged to home with the guidelines-based medical treatment including (DAPT, Atorvastatin, ACEIs, Beta blockers). GLPSS was re-assessed after 1 month. The patients were divided into two groups: improved and non-improved, according to the improvement of LV systolic function measured by GLPSS. Improvement is defined by increase of GLPSS ≥ 10%. Our study demonstrated Improvement of LV function was based on GLPSS and was observed in 54% of the patients. Peak cardiac troponin T level, Peak creatine phosphokinase levels (CPK), LV diastolic function, and baseline GLPSS were identified as independent predictors of recovery of LV function. The patients who showed improvement of GLPSS were associated with improvement of EF (using simpson method).
Objective: Early detection of LV mechanical abnormalities in patients with cardiac syndrome X (CSX) by speckle tracking echocardiography (STE). Background: Cardiac syndrome X is a triad of angina pectoris, positive stress test for myocardial ischemia and angiographically free coronary arteries. Two dimensional speckle tracking echocardiography (2D-STE) provides a more sensitive method for evaluation of global and segmental LV function than conventional two dimensional echocardiographic parameters. Subjects and Methods: Seventy patients proved to have CSX and 20 healthy control volunteers were included with a mean age of 49.43 ± 5.92 vs. 49.40 ± 6.27 years respectively with no difference regarding sex for both patients and controls. Patients with hypertension, diabetes mellitus, valvular heart disease, cardiomyopathies, inflammatory diseases, myocarditis and arrhythmias were excluded. All included individuals were subjected to complete conventional echocardiographic assessment and left ventricular global and segmental mechanical function was assessed using 2D based strain and strain rate (longitudinal, radial and circumferential) imaging. Results: There was no statistically significant difference in LV conventional echo parameters between patients and controls. However, global mean longitudinal strain was significantly lower in patients than controls (−15.05 ± 3.28 vs. −20.22 ± 2.49; p < 0.001). For radial and circumferential strain stain, there was no significant changes between patients vs. controls (29.75 ± 18.26 vs. 28.09 ± 15.48; p = 0.74) and (−19.88 ± 8.63 vs. −21.93 ± 5.69; p < 0.05) respectively. Conclusion: In spite of normal conventional echo parameters among patients and controls, LV longitudinal strain and strain rate by 2D speckle tracking imaging were lower in the patients denoting subclinical left ventricular mechanical dysfunction in patients with CSX.
Background: Long standing aortic stenosis leads to elevated left ventricular (LV) pressure and as a result LV hypertrophy and myocardial fibrosis shall increase. The left ventricular ejection fraction (EF) usually remains adequately-preserved until advanced and late stages of aortic stenosis. But the preserved muscle of the LV is only limited to a portion of the entire myocardium. Speckle tracking echocardiography has proved its superiority to the standard two-dimensional echocardiography method in the detection of Left Ventricular (LV) function. Global Longitudinal strain (GLS) is considered as the most robust myocardial strain component. Objective: The aim of the study is to assess the early course of left ventricular reverse remodelling after Transcutaneous Aortic Valve Implantation (TAVI) in patients with symptomatic severe aortic valve stenosis. Methods: 50 patients with severe symptomatic valvular aortic stenosis undergoing TAVI as decided by the heart team after comprehensive discussion. Standard transthoracic echocardiography including Doppler analysis was performed. 2D speckle-tracking strain assessment of Global radial, circumferential and longitudinal strain at parasternal mid-ventricular short-axis view (at the level of papillary muscle) and from the apical long-axis, two-chamber and four-chamber views with a frame rate between 40 and 80 frames per second. Tracing of endocardial borders was done. Patients with significant coronary artery disease were fully revascularized by percutaneous coronary intervention prior to the study and the procedure. Results: 23 (46%) patients were males, while 27 (54%) were females. The patients' stratification according to comorbidities/associated risk factors re
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