ObjectivesCardiac involvement in patients with systemic sclerosis (SSc) is associated with poor prognosis. Early detection of myocardial impairment is essential for treatment. The present study aimed to systematically review the value of detecting subclinical myocardial impairment in SSc patients using myocardial strain obtained from speckle tracking echocardiography (STE).DesignA systematic review and meta-analysis.Data sourcesThe PubMed, Embase and Cochrane library databases were searched in the period from the earliest available indexing date to 30 September 2022.Eligibility criteria for selecting studiesStudies evaluating myocardial function in SSc patients comparison with healthy controls based on myocardial strain data obtained from STE were included.Data extraction and synthesisVentricle and atrium data on myocardial strain were extracted to assessing the mean difference (MD).ResultsA total of 31 studies were included in the analysis. Left ventricular global longitudinal strain (MD: −2.31, 95% CI −2.85 to –1.76), left ventricular global circumferential strain (MD: −2.93, 95% CI −4.02 to –1.84) and left ventricular global radial strain (MD: −3.80, 95% CI −5.83 to –1.77) was significantly lower in SSc patients than in healthy controls. Right ventricular global wall strain (MD: −2.75, 95% CI −3.25 to –2.25) was also decreased in SSc patients. STE revealed significant differences in several atrial parameters including left atrial reservoir strain (MD: −6.72, 95% CI −10.09 to –3.34) and left atrial conduit strain (MD: −3.26, 95% CI −6.50 to –0.03), as well as right atrial reservoir strain (MD: −7.37, 95% CI −11.20 to –3.53) and right atrial conduit strain (MD: −5.44, 95% CI −9.15 to –1.73). There were no differences in left atrial contractile strain (MD: −1.51, 95% CI −5.34 to 2.33).ConclusionSSc patients have a lower strain than healthy controls for the majority of STE parameters, indicating the presence of an impaired myocardium involving both the ventricle and atrium.
Aims: This study explored the advantages and limitations of novel series of three-dimensional (3D) echocardiographic techniques and summarized their application methods for congenital heart diseases (CHDs).Method and result: Two-dimensional (2D), traditional 3D echocardiography, and TrueVue plus light and/or Glass novel 3D technologies were performed on 62 patients with CHD, and a clinical survey was designed to judge whether the novel 3D images were more helpful for understanding the cardiac condition and guide treatment than traditional 3D images. TrueVue increased the visual resolution and simulated the true texture of cardiac tissue, significantly improving the display ability of abnormal anatomical structures in CHDs. TrueVue Glass displayed the blood channel and the internal structure of cardiac cavity more intuitively, indicating a new observation aspect not shown by conventional echocardiography. The clinical survey results showed that the new 3D imaging methods effectively increased the diagnostic confidence of echocardiographers, enabled surgeons to better understand the details of lesions, promoted efficient communication, and improved the confidence of both doctors and patients in treatment.Conclusion: The combined application of TrueVue, TrueVue Light, and TrueVue Glass more closely simulated real anatomical features, showed more comprehensive and subtle blood flow in the lumen, not only increased the visual effect but also provided more useful diagnostic information, improved the accuracy of evaluation and treatment of CHD when compared to traditional imaging techniques, indicating that this combined application has significant clinical value.
Ventricular diverticulum (VDi) is a rare and often asymptomatic congenital cardiac malformation detected incidentally as an outpouching on routine imaging examination, of which the muscular type has been less reported. Here, two patients were incidentally found to have outpouchings of the ventricle during routine transthoracic echocardiography. After a series of multi‐parameter echocardiography examination, including two‐dimensional (2D), three‐dimensional (3D) photo‐realistic rendering, blood speckle tracking (BST), and contrast enhancement, to provide morphological structure, spatial relationship, and blood flow information, both cases were finally diagnosed with muscular VDi. These cases highlight the advantages of using multi‐parameter echocardiography for the comprehensive assessment of muscular VDi.
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