Archeological Echocardiography: Digitization and Speckle Tracking Analysis of Archival Echocardiograms in the Hyper<scp>GEN</scp> Study

Aguilar, Frank G.; Selvaraj, Senthil; Martinez, Eva E.; Katz, Daniel H.; Beussink, Lauren; Kim, Kwang Youn; Ping, Jie; Rasmussen‐Torvik, Laura J.; Goyal, Anil; Jiang, Sha; Irvin, Marguerite R.; Arnett, Donna K.; Shah, Sanjiv J.

doi:10.1111/echo.13095

Cited by 25 publications

(50 citation statements)

References 29 publications

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“…In addition, for STe′ velocity, the underestimation may be due measurement of average segmental e′ tissue velocity, as opposed to tissue Doppler imaging which measures peak e′ tissue velocity. Despite these limitations, we have demonstrated that correlations between strain values measured prospectively and after digitization are high, especially for longitudinal strain and STe′ velocities (10). There is high correlation between the two methods, though consistent underestimation of e′ velocity by speckle-tracking (Online Figure 1).…”

Section: Methodsmentioning

confidence: 99%

“…In the parasternal short-axis and apical 4 chamber views, 84% and 96% of images had an image quality score of ≥2, respectively, indicating good image quality for the majority of myocardial segments. Data on interobserver and intraobserver reliability shows excellent intraclass correlation coefficients for speckle-tracking parameters (Online Table 1) (10,11). …”

Section: Methodsmentioning

confidence: 99%

“…We leveraged the Hypertension Genetic Epidemiology Network (HyperGEN) Study, a large population- and family-based study—which included overnight urine collections from which urine sodium concentrations were measured, and in which we have previously performed speckle-tracking echocardiographic analysis (10–13). …”

Section: Introductionmentioning

confidence: 99%

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Association of Estimated Sodium Intake With Adverse Cardiac Structure and Function

Selvaraj

Djoussé

Aguilar

et al. 2017

Journal of the American College of Cardiology

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Background The optimal level of sodium intake remains controversial. Objective To determine whether examination of left ventricular (LV) longitudinal and circumferential strain (LS, CS) and e′ velocity can provide insight into thresholds for the detrimental effects of estimated sodium intake (ESI) on subclinical cardiovascular disease. Methods We performed speckle-tracking analysis on Hypertension Genetic Epidemiology study echocardiograms with available urinary sodium data (N = 2,996). We evaluated the association between ESI and LS, CS, and e′ velocity using multivariable-adjusted linear mixed effects models (to account for relatedness among subjects) with linear splines (spline 1: ESI ≤3.7g/day, spline 2: ESI >3.7g/day based upon visual inspection of fractional polynomial plots of the association between ESI and indices of strain and e′ velocity). We performed mediation analysis to understand the indirect effects of systolic blood pressure (SBP) and serum aldosterone on the relationship between ESI and strain and e′ velocity. Results Mean age was 49 ± 14 years, 57% were female, 50% were African American, and 54% had hypertension. The median (25th–75th percentile) ESI was 3.73 (3.24–4.25) g/day. ESI >3.7g/day was associated with larger left atrial and LV dimensions (p <0.05). After adjusting for speckle-tracking analyst, image quality, study site, age, sex, smoking status, alcohol use, daily blocks walked, diuretic use, estimated glomerular filtration rate, LV mass, ejection fraction, and wall motion score index, ESI >3.7g/day was associated with all strain parameters and e′ velocity in (p <0.05 for all comparisons), but ESI ≤3.7g/day was not (p >0.05 for all comparisons). There were significant interactions by potassium excretion for CS. Mediation analysis suggested that SBP explained 14% and 20% of the indirect effects between ESI and LS and e′ velocity, respectively, while serum aldosterone explained 19% of the indirect effects between ESI and LS. Conclusions ESI >3.7 g/day is associated with adverse cardiac remodeling and worse systolic strain and diastolic e′ velocity.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Association of Estimated Sodium Intake With Adverse Cardiac Structure and Function

Selvaraj

Djoussé

Aguilar

et al. 2017

Journal of the American College of Cardiology

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“…A validation of the digitization and speckle-tracking techniques employed here have been published elsewhere. 19 …”

Section: Methodsmentioning

confidence: 99%

Association of Central Adiposity With Adverse Cardiac Mechanics

Selvaraj

Martinez

Aguilar

et al. 2016

Circ: Cardiovascular Imaging

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Background Central obesity, defined by increased waist circumference (WC) or waist-hip ratio (WHR), is associated with increased cardiovascular (CV) events, including heart failure. However, the pathophysiological link between central obesity and adverse CV outcomes remains poorly understood. We hypothesized that central obesity and larger WHR are independently associated with worse cardiac mechanics (reduced left ventricular [LV] strain and systolic [s’] and early diastolic [e’] tissue velocities). Methods and Results We performed speckle-tracking analysis of echocardiograms from participants in the HyperGEN study, a population- and family-based epidemiologic study (N=2181). Multiple indices of systolic and diastolic cardiac mechanics were measured. We evaluated the association between central obesity and cardiac mechanics using multivariable-adjusted linear mixed effects models to account for relatedness among participants. The mean age of the cohort was 51±14 years, 58% were female, and 47% were African-American. Mean body-mass index (BMI) was 30.8±7.1 kg/m2, WC 102±17 cm, WHR 0.91±0.08, and 80% had central obesity based on WC and WHR criteria. After adjusting for multiple potential confounders, including age, sex, race, physical activity, BMI, heart rate, smoking status, systolic blood pressure, fasting glucose, total cholesterol, anti-hypertensive medication use, glomerular filtration rate, LV mass index, wall motion abnormalities, and ejection fraction, central obesity and WHR remained associated with worse global longitudinal strain, early diastolic strain rate, s’ velocity, and e’ velocity (P < 0.05 for all comparisons). There were no significant statistical interactions between WHR and obesity status. Conclusions In this cross-sectional study of participants with multiple comorbidities, central obesity was found to be associated with adverse cardiac mechanics.

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“…A validation of the digitization and speckle-tracking techniques employed here has been published elsewhere. 21 …”

Section: Methodsmentioning

confidence: 99%

Association of Low-Grade Albuminuria With Adverse Cardiac Mechanics

et al. 2014

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Introduction Albuminuria is a marker of endothelial dysfunction and has been associated with adverse cardiovascular outcomes. The reasons for this association are unclear, but may be due to the relationship between endothelial dysfunction and intrinsic myocardial dysfunction. Methods and Results In the HyperGEN study, a population- and family-based study of hypertension, we examined the relationship between urine albumin-to-creatinine ratio (UACR) and cardiac mechanics (N=1894, all of whom had normal left ventricular ejection fraction and wall motion). We performed speckle-tracking echocardiographic analysis to quantify global longitudinal, circumferential, and radial strain (GLS, GCS, and GRS, respectively), and early diastolic (e′) tissue velocities. We used E/e′ ratio as a marker of increased LV filling pressures. We used multivariable-adjusted linear mixed effect models to determine independent associations between UACR and cardiac mechanics. The mean age was 50±14 years, 59% were female, and 46% were African-American. Comorbidities were increasingly prevalent among higher UACR quartiles. Albuminuria was associated with GLS, GCS, GRS, e′ velocity, and E/e′ ratio on unadjusted analyses. After adjustment for covariates, UACR was independently associated with lower absolute GLS (multivariable-adjusted mean GLS [95% CI] for UACR Quartile 1 = 15.3 [15.0–15.5]% vs. UACR Q4 = 14.6 [14.3–14.9]%, P for trend <0.001) and increased E/e′ ratio (Q1 = 25.3 [23.5–27.1] vs. Q4 = 29.0 [27.0–31.0], P= 0.003). The association between UACR and GLS was present even in participants with UACR < 30 mg/g (P<0.001 after multivariable adjustment). Conclusions Albuminuria, even at low levels, is associated with adverse cardiac mechanics and higher E/e′ ratio.

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Archeological Echocardiography: Digitization and Speckle Tracking Analysis of Archival Echocardiograms in the HyperGEN Study

Cited by 25 publications

References 29 publications

Association of Estimated Sodium Intake With Adverse Cardiac Structure and Function

Association of Estimated Sodium Intake With Adverse Cardiac Structure and Function

Association of Central Adiposity With Adverse Cardiac Mechanics

Association of Low-Grade Albuminuria With Adverse Cardiac Mechanics

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