Early Detection of Left Atrial Energy Loss and Mechanics Abnormalities in Diabetic Patients with Normal Left Atrial Size: A Study Combining Vector Flow Mapping and Tissue Tracking Echocardiography

Wang, Yi; Hou, Dailun; Ma, Rongchuan; Ding, Geqi; Yin, Long; Zhang, Mei

doi:10.12659/msm.897385

Cited by 14 publications

(14 citation statements)

References 41 publications

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“…In our study, we did not find an association between LA strain and duration of diabetes or HbA1c, possibly due to the early stage of diastolic dysfunction detected. Prior echocardiographic data support a primary atrial myopathy in diabetes [27, 28]. Our study demonstrated alterations of conduit longitudinal strain and motion fraction, changes which are supportive of primary alterations of LV relaxation associated with mild diastolic dysfunction [29].…”

Section: Discussionsupporting

confidence: 75%

Impact of obesity and epicardial fat on early left atrial dysfunction assessed by cardiac MRI strain analysis

Evin

Broadhouse

Callaghan

et al. 2016

Cardiovasc Diabetol

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Background: Diastolic dysfunction is a major cause of morbidity in obese individuals. We aimed to assess the ability of magnetic resonance imaging (MRI) derived left atrial (LA) strain to detect early diastolic dysfunction in individuals with obesity and type 2 diabetes, and to explore the association between cardiac adipose tissue and LA function.Methods: Twenty patients with obesity and T2D (55 ± 8 years) and nineteen healthy controls (48 ± 13 years) were imaged using cine steady state free precession and 2-point Dixon cardiovascular magnetic resonance. LA function was quantified using a feature tracking technique with definition of phasic longitudinal strain and strain rates, as well as radial motion fraction and radial velocities.Results: Systolic left ventricular size and function were similar between the obesity and type 2 diabetes and control groups by MRI. All patients except four had normal diastolic assessment by echocardiography. In contrast, measures of LA function using magnetic resonance feature tracking were uniformly altered in the obesity and type 2 diabetes group only. Although there was no significant difference in intra-myocardial fat fraction, Dixon 3D epicardial fat volume(EFV) was significantly elevated in the obesity and type 2 diabetes versus control group (135 ± 31 vs. 90 ± 30 mL/m 2 , p < 0.001). There were significant correlations between LA functional indices and both BMI and EFV (p ≤ 0.007).Conclusions: LA MRI-strain may be a sensitive tool for the detection of early diastolic dysfunction in individuals with obesity and type 2 diabetes and correlated with BMI and epicardial fat supporting a possible association between adiposity and LA strain.

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Section: Discussionsupporting

confidence: 75%

Impact of obesity and epicardial fat on early left atrial dysfunction assessed by cardiac MRI strain analysis

Evin

Broadhouse

Callaghan

et al. 2016

Cardiovasc Diabetol

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“…Vorticity represents the direction and strength of local vortex rotation. Numerous investigations have confirmed the utility of these new parameters …”

Section: Introductionmentioning

confidence: 85%

“…The optimized blood flow dynamics can reflect the general function of left ventricle and the ability of cardiovascular system in maintaining the relative stabilization of blood circulation . The change in intra‐ventricular blood flow‐pattern is related to the diastolic filling .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of left ventricular diastolic function based on flow energetic parameters in chronic kidney disease with diastolic dysfunction

Wang

Chen

et al. 2019

Echocardiography

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Background Intra‐ventricular blood flow dynamics is considered as an important component of left ventricular (LV) function assessment. The purpose of this study was to evaluate the LV diastolic function in chronic kidney disease (CKD) with different degrees of LV diastolic dysfunction (LVDD) by using flow energetic parameters. Methods In this study, a total of 96 cases were recruited, including 58 CKD patients and 38 healthy controls. CKD patients were divided into 2 groups according to LVDD severity, named as DD1 and DD2. Vector flow‐mapping (VFM) analysis was executed to calculate left ventricle average energy loss (EL) during early filling phase (E‐EL_ave), atrial filling phase (A‐EL_ave), diastole phase (D‐EL_ave), and ejection phase (S‐EL_ave). Moreover, the average vortex circulation during early filling phase (E‐cir_ave) and atrial filling phase (A‐cir_ave) was also assessed in the apical three‐chamber view. The rate of average EL during early filling and atrial filling was expressed as E/A‐EL. Result Compared to the control group, A‐EL_ave, S‐EL_ave, and A‐cir_ave in the DD1 group were higher (P < 0.05), and all parameters were obviously higher in the DD2 group (P < 0.05). In the control group and the DD2 subgroup, the E‐EL_ave value was significantly higher than A‐EL_ave value, which was opposite to the DD1 group. As diastolic dysfunction worsened, E‐EL_ave and D‐EL_ave risen gradually (P < 0.05), and A‐EL_ave and S‐EL_ave were slightly elevated with no significance. There were significant correlations between LV diastolic function and flow energetic parameters. Stepwise multiple regression analysis revealed that various LV function parameters could be regarded as independent predictors of average diastolic EL (all P < 0.01). Conclusions For CKD patient with LVDD and LVEF > 50%, effective LV filling and systolic ejection with optimized energy consumption have been impaired. As a new flow‐derived index, EL can quantitatively evaluate LV diastolic function in terms of blood fluid dynamics in CKD with various LVDD.

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“…Blood flow patterns inside the cardiac chamber are affected by the anatomical structure of the heart and valves, as well as the motion of myocardial and intracardiac pressure. Together, these factors generate the flow order reflecting normal or pathological physiology . Energy loss (EL) is a new hemodynamic index for assessing cardiac function that is caused by friction produced between the flowing blood and wall shear flow due to blood viscosity, which converts kinetic energy to heat.…”

Section: Introductionmentioning

confidence: 99%

Characterization of left ventricle energy loss in healthy adults using vector flow mapping: Preliminary results

Sun

Zhu

et al. 2017

Echocardiography

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Energy loss in LV changes regularly during the cardiac cycle. The average systolic EL has a high positive correlation with AOVTI, whereas the average diastolic EL has with E-wave peak velocity. Women have higher average EL than men in both systole and diastole. By recognizing the EL characterization of healthy adults, the variation in EL may reflect cardiac dysfunction. These were preliminary results, and thus, the clinical implications of EL warrant further investigation.

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Early Detection of Left Atrial Energy Loss and Mechanics Abnormalities in Diabetic Patients with Normal Left Atrial Size: A Study Combining Vector Flow Mapping and Tissue Tracking Echocardiography

Cited by 14 publications

References 41 publications

Impact of obesity and epicardial fat on early left atrial dysfunction assessed by cardiac MRI strain analysis

Impact of obesity and epicardial fat on early left atrial dysfunction assessed by cardiac MRI strain analysis

Evaluation of left ventricular diastolic function based on flow energetic parameters in chronic kidney disease with diastolic dysfunction

Characterization of left ventricle energy loss in healthy adults using vector flow mapping: Preliminary results

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