Is treated hypopituitarism associated with increased left ventricular strains?—detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study

Nemes, Attila; Kormányos, Árpád; Gyenes, Nándor; Ambrus, Nóra; Horváth, Ágnes; Lengyel, Csaba; Valkusz, Zsuzsanna

doi:10.21037/qims-21-113

Cited by 4 publications

(5 citation statements)

References 17 publications

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“…Mihaila et al presented decreased 2DSTE-derived longitudinal (LS) and circumferential strains in the presence of GH deficiency, which was accompanied with impaired LV basal rotation and twist (29). In contrast, increased 3DSTE-derived LS and area strain could be detected in our group of patients with treated hypopituitarism in a recent study, in which most cases had GH deficiency (19). In the present study, reduced LV twist was associated with impaired LV apical rotation and preserved LV basal rotation in patients with normally directed LV rotational mechanics, in which abnormalities were present regardless of the type of hypopituitarism (congenital vs. acquired).…”

Section: Discussioncontrasting

confidence: 48%

“…Early detection of changes in LV volumetric and functional abnormalities could help in selecting patients with increased risk. In recent studies, diagnostic and prognostic impact of LV deformation have been demonstrated in several disorders (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). LV has a special 3D movement respecting the cardiac cycle as well due to its special helical 3D structure.…”

Section: Discussionmentioning

confidence: 99%

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Left Ventricular Rotational Abnormalities in Treated Hypopituitarism: Insights From the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study

Kormányos

Gyenes

Horváth

et al. 2021

Front. Cardiovasc. Med.

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Introduction: Hypopituitarism is a rare, often underdiagnosed, complex hormonal disease caused by the decreased secretion of one or more hormones in the pituitary gland. The present study was designed to assess left ventricular (LV) rotational mechanics in patients with treated hypopituitarism. It was also aimed to find possible differences in these parameters according to the origin of hypopituitarism (congenital vs. acquired).Methods: The present prospective study involved 35 treated patients with hypopituitarism; however, 4 patients had to be excluded due to inferior image quality. The mean age of the remaining 31 cases was 56.3 ± 13.2 years (18 males). The control group consisted of 29 age- and sex-matched healthy volunteers (mean age: 55.3 ± 4.8 years, 14 males). In all cases a complete two-dimensional echocardiography examination was performed followed by three-dimensional speckle-tracking echocardiography.Results: No significant differences could be found in LV volumes between the controls and patients with hypopituitarism and hypopituitary subgroups. LV apical rotation (8.1 ± 5.1° vs. 10.6 ± 3.5°, p < 0.05) and LV twist (11.9 ± 5.3° vs. 15.1 ± 3.8°, p < 0.05) were impaired in the hypopituitary group with normally directed LV rotational mechanics as compared to the healthy controls. However, 13% of patients showed a near absence of LV twist called LV “rigid body rotation” (LV-RBR). There were no significant differences regarding LV apical and basal rotations and twist between acquired and congenital hypopituitary subgroups.Conclusions: Impaired LV apical rotation and twist could be demonstrated in hypopituitarism regardless of its origin. In the present study with small number of patients with hypopituitarism, LV-RBR was present in 13% of cases.

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Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Left Ventricular Rotational Abnormalities in Treated Hypopituitarism: Insights From the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study

Kormányos

Gyenes

Horváth

et al. 2021

Front. Cardiovasc. Med.

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“…❖ Moreover, volumetric and functional features of other cardiac chambers were also not examined ( 18 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

“… Direct comparison of 2D echocardiography-and 3DSTE-derived RA parameters was not aimed to be performed.  Moreover, volumetric and functional features of other cardiac chambers were also not examined (18,19).  Only 3DSTE-derived RA volumes were measured.…”

Section: Limitation Sectionmentioning

confidence: 99%

Right atrial volumes and strains in healthy adults: is the Frank-Starling mechanism working?—detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study

Nemes¹,

Kormányos²

2023

Quant Imaging Med Surg

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Background: With larger blood volume flowing into a cardiac chamber, by stretching muscle fibers, increased contraction force could be detected. This phenomenon is called Frank-Starling mechanism, allowing the output of a cardiac chamber to be synchronized without external regulation. The purpose of the present study was to investigate the Frank-Starling mechanism in the right atrium (RA) represented by its volumes, volume-based functional properties and strains respecting the cardiac cycle in healthy adults by three-dimensional (3D) speckle-tracking echocardiography (3DSTE). Methods:The present single center retrospective cohort study comprised 179 healthy adult volunteers (mean age: 33.2±12.0 years, 92 males), in whom complete two-dimensional Doppler echocardiography with 3DSTE was performed. Subjects were divided into 3 groups according to the mean value of maximum RA volume (V max ) ± standard deviation: V max <30 mL, 30 mL ≤ V max <60 mL and V max ≥60 mL.Results: All RA volumes respecting the cardiac cycle of all subjects and calculated separately for females and males and their indexed equivalents increased with V max . RA stroke volumes increased with V max regardless of the phase it was measured in. While total atrial emptying fraction representing the reservoir phase remained unchanged with the increase of V max , a significant increase in passive atrial emptying fraction representing the conduit phase could be detected, in case of V max >60 mL (28.9%±15.1% vs. 32.5%±12.6%, P<0.05).Active atrial emptying fraction representing the booster pump function did not change with the increase of V max . Most global and mean segmental peak RA strains did not show significant changes with increasing RA volumes except for the RA area strain, it was the largest when V max was larger than 60 mL (64.7%±44.9% vs. 83.3%±49.4%, P<0.05). RA circumferential, longitudinal and area strains at atrial contraction decreased with increasing V max , RA radial and 3D strains did not change significantly with increasing V max .Conclusions: Increasing RA volumes do not cause significant increase in RA contractility represented by strains, but reduction in strains in longitudinal and circumferential directions could be detected in enddiastolic booster pump function. In contrast to the left atrium, obvious signs of Frank-Starling mechanism could not be detected in case of the RA.

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“…❖ Known technical limitations of 3DSTE are reduced spatial resolution and lower frame rate as compared to 2DE ( 4 - 7 , 19 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

Left ventricular deformation in patients with lymphedema before and after the use of medical compression stockings—detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study

Nemes,

Kormányos,

Ambrus

et al. 2023

Quant Imaging Med Surg

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Background Lymphedema (LE) is a chronic condition, which refers to tissue swelling due to excess interstitial fluid accumulation or impaired lymphatic conduit. Theoretically, lymphedema-related fluid retention could affect left ventricular (LV) mechanics, which could be detailed by recent three-dimensional speckle-tracking echocardiography. Therefore, it was purposed to examine LV strains in LE patients before and one hour after the use of medical compression stockings and to compare findings to those of matched normal subjects. Methods The study comprised 26 cases with lymphedema, however, 4 cases had to be excluded due to inferior quality of images. Their results were compared to 27 age- and gender-matched healthy controls. Results Global LV circumferential and area strains and mean segmental LV circumferential strain were increased in lymphedema patients before the use of medical compression stockings as compared to controls. One hour after the use of medical compression stockings, no global and mean segmental LV strain showed significant impairment or improvement, but tendentious reduction was seen in LV circumferential strain. With LV segmental analysis, midventricular LV radial, circumferential and area strains proved to be significantly increased, while basal LV longitudinal strain and midventricular LV three-dimensional strain were decreased as compared to controls. No changes in regional LV strains could be detected after one-hour medical compression stockings use as compared to data collected at rest. Conclusions Increased global LV circumferential strain is seen in lymphedema. With using medical compression stockings, LV deformation parameters change towards the normal range emphasizing their importance on cardiac function.

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Is treated hypopituitarism associated with increased left ventricular strains?—detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study

Cited by 4 publications

References 17 publications

Left Ventricular Rotational Abnormalities in Treated Hypopituitarism: Insights From the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study

Left Ventricular Rotational Abnormalities in Treated Hypopituitarism: Insights From the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study

Right atrial volumes and strains in healthy adults: is the Frank-Starling mechanism working?—detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Healthy Study

Left ventricular deformation in patients with lymphedema before and after the use of medical compression stockings—detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study

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