Could quantitative longitudinal peak systolic strain help in the detection of left ventricular wall motion abnormalities in our daily echocardiographic practice?

Background. Left ventricular ejection fraction (LVEF) and end diastolic volume (EDV) are measured using Simpson’s biplane (SB), 3-dimensional method (3DE), and speckle tracking (STE). Comparisons between methods in routine practice are limited. Our purpose was to compare and to determine the correlations between these three methods in clinical setting. Methods. LVEF and EDV were measured by three methods in 474 consecutive patients and compared using multiple Bland–Altman (BA) plots. The correlations (R) between methods were calculated. Results. Median (IQR) LVEF_SB, LVEF_STE, and LVEF_3DE were 63.0% (60–69)%, 61% (57–65)%, and 62% (57–68)%. Median (IQR) EDV_SB, EDV_STE, and EDV_3DE were 85 ml (71–106) ml, 82 ml (69–100) ml, and 73 ml (59–89) ml. R between LVEF_SB and LVEF_3DE was 0.65 when echogenicity was good and 0.43 when poor. R for EDV_SB and EDV_3DE was 0.75 when echogenicity was good and 0.45 when poor. On BA analysis, biases were acceptable (<3.5% for LVEF) but limits of agreement (LOA) were large: 95% of the differences were between −15.4% and +18.8% for LVEF as evaluated by SB in comparison with 3DE, with a bias of 1.7%. In the comparison EDV_SB and EDV_3DE, the bias was 14 ml and the LOA were between −24 ml and +53 ml. On linear regressions, LVEF_3DE = 17.92 + 0.69 LVEF_SB and EDV_3DE = 18.94 + 0.63 EDV_SB. Conclusions. The three methods were feasible and led to acceptable bias but large LOA. Although these methods are not interchangeable, our results allow 3DE value prediction from SB, the most commonly used method.

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“…Well-designed trials are indeed essential. Although real life practice may sometimes be different, it also deserves to be explored [7,8].…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular End Diastolic Volume and Ejection Fraction Calculation: Correlation between Three Echocardiographic Methods

Benyounes

Vynckt

Tibi

et al. 2020

Cardiology Research and Practice

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“…Myocardial LS was assessed by STE in accordance with the current recommendations [15] using the 17-segment LV model to visually assess the nature of its lesion (Figure 1). Patients with a lesion of segmental LS (≥3 LV segments) constituted Group I (n=108); study subjects without LS impairment formed Group II (n=108) [16]. Lesions of ≥4 segments of the same LV level were considered diffuse LS impairment (Figure 1).…”

Section: Analyzing Echocardiographymentioning

confidence: 99%

Left Ventricular Segmental Strain Based On Speckle Tracking Echocardiography Versus Indications Of Immune Inflammation In Patients After COVID-19 Pneumonia

et al. 2023

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Background — The significance of cytokine activation and immune inflammation in subclinical damage to cardiomyocytes and resulting development of the congestive heart failure (CHF) is frequently discussed in published studies, as well as whether there are cardiac lesions in COVID-19 survivors identified by the speckle tracking echocardiography (STE). Objective — To examine the association of echocardiographic parameters with indications of immune inflammation in patients recovered from COVID-19 pneumonia depending on segmental longitudinal strain (LS) of the left ventricle (LV) identified by STE. Methods — Our study encompassed 216 patients (51.1% men, mean age of 50.1±11.1 years) distributed among two groups: Group I (n=108) included study subjects with segmental LS (≥3 LV segments) revealed by the STE; Group II (n=108) comprised patients without visually detectable LV lesions. All patients were examined three months after COVID-19 pneumonia. Results — Groups did not differ statistically significantly in terms of LV ejection fraction (68.7±4.3% in Group I vs. 68.6±4.3% in Group II; p=0.916). Global LS was significantly lower in the Group I than in the Group II at the time of the control follow-up visit three months later (-18.2 [-16.7; -19.4] % vs. -20.6 [-19.5; -22.1] %, respectively; p<0.001). When analyzing laboratory indications of immune inflammation in groups, we revealed statistically significantly higher values in Group I vs. Group II in the concentrations of interleukin 6 (3.1 [2.4;3.9] pg/mL vs. 2.5 [3.8;4.7] pg/mL; p=0.009), C-reactive protein (4.7 [2.9;8.3] mg/L vs. 3.0 [1.5; 5.3] mg/L; p<0.001), and tumor necrosis factor α (6.0 [4.8;4.1] pg/ml vs. 5.0 [4.0;6.4] pg/ml; p=0.001). In Group I, we detected diffuse lesion of LS (≥4 segments of the same LV level; 38.0% of patients) and regional lesion of LS (≥3 segments corresponding to the blood supply pools of the anterior, circumflex, or right coronary arteries; 62.0% of patients). According to logistic regression, the LS of the basal LV level (OR 3.028; 95% CI 1.909-4.802; р<0.001) in combination with LS of the apical LV level (OR 1.287; 95% CI 1.099-1.507; р=0.002) and LV lateral wall annular velocity assessed by tissue Doppler imaging, peak e’ (OR 0.774; 95% CI 0.657-0.911; р=0.002) had an independent relationship with each of diffuse and regional LS lesions. Conclusion — Based on STE data, we have identified a relationship of diffuse and regional LV lesions with features of systolic and diastolic LV dysfunction and markers of immune inflammation in patients three months after COVID-19 pneumonia.

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“…However, in the real-life practice, we are very committed to this part of the medical practice [ 8 – 10 ] and we often have to adapt the recommendations and guidelines to the circumstances. This is why we had to perform TTEs/TEEs on COVID-19 patients admitted to our institution.…”

Section: Introductionmentioning

confidence: 99%

Echocardiography in Confirmed and Highly Suspected Symptomatic COVID-19 Patients and Its Impact on Treatment Change

Benyounes

Vynckt

Tibi

et al. 2020

Cardiology Research and Practice

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Background. COVID-19 interacts at multiple levels with the cardiovascular system. The prognosis of COVID-19 infection is known to be worse for patients with underlying cardiovascular diseases. Furthermore, the virus is responsible for many cardiovascular complications. Myocardial injury may affect up to 20% of the critically ill patients. However, echocardiography’s impact on the management of patients affected by COVID-19 remains unknown. Objectives. To explore echocardiography’s impact on the management of COVID-19 patients. Methods. This study was conducted from March 24th to April 14th, 2020, in a single center at Adolphe de Rothschild Foundation Hospital, Paris, France. All consecutive inpatients with laboratory and/or CT COVID-19 diagnosis were included in this study. Patients’ characteristics (clinical, biological, and imaging) and treatment change induced by echocardiography were collected and analyzed. Patients with and without treatment change induced by echocardiography were compared. Results. A total of 56 echocardiographies in 42 patients with highly suspected or confirmed COVID-19 were included in the final analyses. The median age was 66 (IQR 60.5–74). Echocardiography induced a treatment change in 9 cases (16%). The analyzed clinical data were not associated with any treatment change induced by echocardiography. D-dimer and Troponin levels were the only biological predictors of the induced treatment change. On echocardiography, higher systolic pulmonary arterial pressure and documented cardiac thrombi were associated with treatment changes in these patients. Conclusions. Echocardiography may be useful for the management of selected COVID-19 patients, especially those with elevated D-Dimer and Troponin levels, in up to 16% of patients.

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Could quantitative longitudinal peak systolic strain help in the detection of left ventricular wall motion abnormalities in our daily echocardiographic practice?

Abstract: Segmental LPSS values may help to differentiate between normal and abnormal left ventricular segments.

Cited by 4 publications

References 14 publications

Left Ventricular End Diastolic Volume and Ejection Fraction Calculation: Correlation between Three Echocardiographic Methods

Left Ventricular End Diastolic Volume and Ejection Fraction Calculation: Correlation between Three Echocardiographic Methods

Left Ventricular Segmental Strain Based On Speckle Tracking Echocardiography Versus Indications Of Immune Inflammation In Patients After COVID-19 Pneumonia

Echocardiography in Confirmed and Highly Suspected Symptomatic COVID-19 Patients and Its Impact on Treatment Change

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