Does layer-specific strain using speckle tracking echocardiography improve the assessment of left ventricular myocardial deformation? A review

Ancédy, Yann; Éderhy, Stéphane; Jean, Marie-Liesse; Nhan, Pascal; Soulat-Dufour, Laurie; Adavane-Scheublé, Saroumadi; Chauvet-Droit, Marion; Boccara, Franck

doi:10.1016/j.acvd.2020.05.007

Cited by 16 publications

(16 citation statements)

References 38 publications

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“…The results of the LSS assessment showed a significant decrease in LV three-layer LS and CS and transmural strain gradient in patients with SLE compared to the healthy controls. Furthermore, when assessing LV systolic function with more sensitive tools such as endocardial LS and CS were significantly lower than in control subjects in a certain percentage of patients was substantially impaired according to the normal values proposed by a current study [21,22]. These findings suggest that subclinical impairment of left ventricular function can occur even when LVEF still remains in the normal range in patients with SLE.…”

Section: Discussionsupporting

confidence: 57%

Evaluation of Left Ventricular Systolic Function in Patients With Systemic Lupus Erythematosus Using Ultrasonic Layer-specific Strain Technology and Its Association With Cardiovascular Events: a Long-term Follow-up Study

Zhang¹,

Yang²,

Gao³

et al. 2021

Preprint

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Background: Systemic lupus erythematosus (SLE) is a multisystem, autoimmune disease with potential cardiovascular involvement. Layer-specific strain (LSS) analysis is a new method that allows early detection of subtle LV systolic dysfunction. The aim of this study was to evaluate left ventricular (LV) systolic function in patients with SLE using conventional echocardiographic measurements and longitudinal strain (LS) and circumferential strain (CS) by LSS. Furthermore, the association between echocardiographic parameters and the occurrence of cardiovascular events was assessed. Methods: A total of 162 patients with SLE (the SLE group) who underwent a dedicated multidisciplinary assessment, including echocardiography, were analyzed at the time of their first visits. The control group consisted of 68 age- and sex-matched healthy subjects. LS and CS on endocardial, mid-myocardial, and epicardial layers at 17 cardiac segments were measured. Transmural strain gradient was calculated as the differences in systolic strain between the endocardial and epicardial layers.Results: Compared with control subjects, patients with SLE had significantly lower LV ejection fraction, LS, and CS values in all layers (P<0.05); LV LS and CS gradient were all lower than control subjects(P<0.05). During a median follow-up period of 83 months (interquartile range: 64-95 months), 59 patients (36.4%) developed cardiovascular events. Using multivariate Cox regression analysis, we found that LV endocardial LS (hazard ratio, 1.022;95% CI,0.992-1.046; P=0.037) and CS (hazard ratio, 1.052;95% CI, 1.028-1.046; P<0.001) demonstrated independent associations with cardiovascular events; whereas LV ejection fraction was not significantly associated with cardiovascular events. The Kaplan-Meier survival curves showed that patients with SLE with lower LV endocardial LS and CS (based on the cutoff values of -21.5% and -29.0%, respectively) experienced higher cumulative rates of cardiovascular events compared with those with higher LV endocardial LS and CS. Conclusions: In patients with SLE, LV systolic function measured by LV endocardial LS and CS were significantly lower than that of the control group and were associated with cardiovascular events, potentially representing a new technology to improve risk stratification in these patients.

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Section: Discussionsupporting

confidence: 57%

Evaluation of Left Ventricular Systolic Function in Patients With Systemic Lupus Erythematosus Using Ultrasonic Layer-specific Strain Technology and Its Association With Cardiovascular Events: a Long-term Follow-up Study

Zhang¹,

Yang²,

Gao³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The results of the LSS assessment showed a significant decrease in LV three-layer LS and CS and transmural strain gradient in patients with SLE compared to the healthy controls. Furthermore, when assessing LV systolic function with more sensitive tools such as endocardial LS and CS were significantly lower than in control subjects in a certain percentage of patients was substantially impaired according to the standard values proposed by a current study [21,22]. These findings suggest that subclinical impairment of LV function can occur even when LVEF remains in the normal range in patients with SLE.…”

Section: Systolic Function In Patients With Slesupporting

confidence: 53%

Evaluation of left ventricular systolic function in patients with systemic lupus erythematosus using ultrasonic layer-specific strain technology and its association with cardiovascular events: a long-term follow-up study

Zhang

Yang

Gao

et al. 2022

Cardiovasc Ultrasound

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Background Systemic lupus erythematosus (SLE) is a multisystem, autoimmune disease with potential cardiovascular involvement. Layer-specific strain (LSS) analysis is a new method that allows early detection of subtle left ventricular (LV) systolic dysfunction. The aim of this study was to evaluate LV systolic function in patients with SLE using conventional echocardiographic measurements and longitudinal strain (LS) and circumferential strain (CS) by LSS. Furthermore, the association between echocardiographic parameters and the occurrence of cardiovascular events was assessed. Methods A total of 162 patients with SLE (the SLE group) who underwent a dedicated multidisciplinary assessment, including echocardiography, were analyzed at the time of their first visits. The control group consisted of 68 age- and sex-matched healthy subjects. LS and CS on endocardial, mid-myocardial, and epicardial layers at 17 cardiac segments were measured. Transmural strain gradient was calculated as the differences in systolic strain between the endocardial and epicardial layers. Results Compared with control subjects, patients with SLE had significantly lower LV ejection fraction, LS, and CS values in all layers (P < 0.05); LV LS and CS gradient were all lower than control subjects (P < 0.05). During a median follow-up period of 83 months (interquartile range: 64–95 months), 59 patients (36.4%) developed cardiovascular events. Using multivariate Cox regression analysis, we found that LV endocardial LS (hazard ratio, 1.014; 95% CI, 1.002–1.035; P = 0.025) and CS (hazard ratio, 1.051; 95% CI, 1.027–1.077; P < 0.001) demonstrated independent associations with cardiovascular events; whereas LV ejection fraction was not significantly associated with cardiovascular events. The Kaplan–Meier survival curves showed that patients with SLE with lower LV endocardial LS and CS (based on the cutoff values of -21.5% and -29.0%, respectively) experienced higher cumulative rates of cardiovascular events compared with those with higher LV endocardial LS and CS. Conclusions In patients with SLE, LV systolic function measured by LV endocardial LS and CS were significantly lower than that of the control group and were associated with cardiovascular events, potentially representing a new technology to improve risk stratification in these patients

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“…Studies have shown that in patients with chest pain suspected to be caused by coronary artery disease, LSS assessment enables the detection of non-ST-segment elevation acute coronary syndrome; furthermore, LSS can be used to identify transmural and non-transmural infarction and enables the detection of subclinical myocardial impairment in patients with cardiovascular risk factors. [5][6][7] The purpose of this study was to explore the clinical feasibility and value of aCMQ in evaluating fetal ventricular myocardial strain.…”

Section: Introductionmentioning

confidence: 99%

Quantitative evaluation of fetal ventricular function by speckle tracking echocardiography

et al. 2021

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Methods:The study included 59 patients with normal fetal heart structure, blood flow, and heart rhythm (fetal abnormality-negative group) and 50 patients with abnormal fetal heart structure, blood flow, and/or heart rhythm (fetal abnormality-positive group). Automated Cardiac Motion Quantification (aCMQ) was performed in both groups to obtain left and right ventricular endocardial global longitudinal strain (GLSendo), mid-myocardial global longitudinal strain (GLSmid), and epicardial global longitudinal strain (GLSepi). Parameters between the two groups were compared and correlation analyses performed. A deformation analysis was performed by two trained observers, and reproducibility was assessed. Results:The fetal left ventricular and right ventricular global longitudinal strain (LV-GLS and RV-GLS, respectively) decreased in a gradient from the endocardium to the epicardium. LV-GLS and RV-GLS of all myocardial layers were lower in the fetal abnormality-positive than -negative group (all P < 0.05). Correlation analysis showed that neither LV-GLS nor RV-GLS was significantly correlated with gestational age in the fetal abnormality-negative group (all P > 0.05), whereas left ventricular GLSendo, GLSmid, and GLSepi were negatively correlated with gestational age in the fetal abnormality-positive group (r = −.39 to −.44, all P < 0.05). Repeatability testing showed that the inter-observer and intra-observer intra-class correlation coefficients for LV-GLS and RV-GLS in each myocardial layer were >.75 (all P < 0.001). Conclusions:As a new speckle tracking echocardiography tool, aCMQ has feasibility and repeatability in evaluating myocardial deformation of the fetal ventricle. This technique might provide helpful information on ventricular myocardial deformation in fetal hearts with abnormal structure or rhythm for clinical guidance in pregnancy.

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Does layer-specific strain using speckle tracking echocardiography improve the assessment of left ventricular myocardial deformation? A review

Cited by 16 publications

References 38 publications

Evaluation of Left Ventricular Systolic Function in Patients With Systemic Lupus Erythematosus Using Ultrasonic Layer-specific Strain Technology and Its Association With Cardiovascular Events: a Long-term Follow-up Study

Evaluation of Left Ventricular Systolic Function in Patients With Systemic Lupus Erythematosus Using Ultrasonic Layer-specific Strain Technology and Its Association With Cardiovascular Events: a Long-term Follow-up Study

Evaluation of left ventricular systolic function in patients with systemic lupus erythematosus using ultrasonic layer-specific strain technology and its association with cardiovascular events: a long-term follow-up study

Quantitative evaluation of fetal ventricular function by speckle tracking echocardiography

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