Left Ventricular Myocardial Contractile Reserve during Exercise Stress in Healthy Adults: A Two-Dimensional Speckle-Tracking Echocardiographic Study

Larsen, Anders Hostrup; Clemmensen, Tor Skibsted; Wiggers, Henrik; Poulsen, Steen Hvitfeldt

doi:10.1016/j.echo.2018.06.010

Cited by 33 publications

(21 citation statements)

References 39 publications

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“…Echocardiographic examinations were performed in all patients at rest according to previously described methods 22 and current guidelines 23 . Exercise echocardiography was performed during simultaneous cardiopulmonary exercise testing 22 (online supplementary Methods ).…”

Section: Methodsmentioning

confidence: 99%

A randomised, double‐blind, placebo‐controlled trial of metformin on myocardial efficiency in insulin‐resistant chronic heart failure patients without diabetes

Larsen

Jessen

Nørrelund

et al. 2019

European J of Heart Fail

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Section: Methodsmentioning

confidence: 99%

A randomised, double‐blind, placebo‐controlled trial of metformin on myocardial efficiency in insulin‐resistant chronic heart failure patients without diabetes

Larsen

Jessen

Nørrelund

et al. 2019

European J of Heart Fail

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“…Prior to myocardial tracking, aortic valve opening and closure were defined by the event timing function. Subsequent calculation of peak systolic myocardial strain was software-generated using the automated function Q-Analysis module 11 .…”

Section: Methodsmentioning

confidence: 99%

Myocardial strain assessed by feature tracking cardiac magnetic resonance in patients with a variety of cardiovascular diseases – A comparison with echocardiography

Pryds

Larsen

Hansen

et al. 2019

Sci Rep

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Myocardial deformation assessed by speckle tracking echocardiography (STE) is increasingly used for diagnosis, monitoring and prognosis in patients with clinical and pre-clinical cardiovascular diseases. Feature tracking cardiac magnetic resonance (FT-CMR) also allows myocardial deformation analysis. To clarify whether the two modalities can be used interchangeably, we compared myocardial deformation analysis by FT-CMR with STE in patients with a variety of cardiovascular diseases and healthy subjects. We included 40 patients and 10 healthy subjects undergoing cardiac magnetic resonance and echocardiographic examination for left ventricular volumetric assessment. We studied patients with heart failure and reduced ejection fraction (n = 10), acute perimyocarditis (n = 10), aortic valve stenosis (n = 10), and previous heart transplantation (n = 10) by global longitudinal (GLS), radial (GRS) and circumferential strain (GCS). Myocardial deformation analysis by FT-CMR was feasible in all but one participant. While GLS, GRS and GCS measured by FT-CMR correlated overall with STE (r = 0.74 and p < 0.001, r = 0.58 and p < 0.001, and r = 0.76 and p < 0.001), the correlations were not consistent within subgroups. GLS was systematically lower, whereas GRS and GCS were higher by FT-CMR compared to STE (p = 0.04 and p < 0.0001). Inter- and intra-observer reproducibility were comparable for FT-CMR and STE overall and across subgroups. In conclusion, myocardial deformation can be evaluated using FT-CMR applied to routine cine-CMR images in patients with a variety of cardiovascular diseases. However, correlation between FT-CMR and STE was modest and agreement was not optimal due to systematic bias regarding GLS and GCS. Consequently, FT-CMR and STE should not be used interchangeably for myocardial strain evaluation.

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“…Previous studies have shown that the effect of age on several parameters during peak exercise, including left ventricular global longitudinal strain, appeared to be marginal, and that no significant difference was noted between women and men for these parameters. 36,37 These findings may suggest that differences between patients with repaired tetralogy of Fallot and controls based on exercise are much larger than the differences based on age and sex. However, further large-scale studies are needed to confirm whether early detection of potential myocardial damage allows early therapeutic intervention to improve late ventricular dysfunction.…”

Section: Study Limitationsmentioning

confidence: 93%

Exercise echocardiography demonstrates potential myocardial damage in patients with repaired tetralogy of Fallot using layer-specific strain analysis

et al. 2020

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Introduction:Exercise stress echocardiography and layer-specific strains are emerging as important tools for cardiac assessment. This study was aimed to evaluate layer-specific strains and torsion parameters during exercise in order to investigate the characteristics of cardiac dysfunction in patients with repaired tetralogy of Fallot and to detect subclinical left ventricular dysfunction.Materials and Methods:Thirteen patients with repaired tetralogy of Fallot (median age, 17.3 [interquartile range, 14.5–22.9] years; 6 males) and 13 controls (median age, 28.5 [interquartile range, 27.6–31.6] years; 13 males) underwent echocardiography at rest and during supine exercise. Layer-specific longitudinal strain and circumferential strain of three myocardial layers (endocardium, midmyocardium, and epicardium), torsion, and untwisting rate were measured using two-dimensional speckle-tracking echocardiography.Results:Peak endocardial papillary circumferential strain (−21.1 ± 2.6% vs. −25.8 ± 3.8%, p = 0.007), midmyocardial apical circumferential strain (−11.1 ± 4.0% vs. −15.6 ± 3.2%, p = 0.001), epicardial apical circumferential strain (−11.1 ± 4.0% vs. −15.6 ± 3.2%, p = 0.021), and torsion (8.9 ± 6.0 vs. 14.9 ± 4.8 degree, p = 0.021) were significantly lower in the repaired tetralogy of Fallot group than in the control group during exercise, though no significant difference was found between patients and controls at rest.Conclusions:Analysis of layer-specific strains and torsion parameters during exercise could detect subclinical left ventricular dysfunction in patients with repaired tetralogy of Fallot, which might reflect potential myocardial damage, at a stage where these parameters have normal values at rest. This finding provides new insight into the mechanisms of cardiac dysfunction in patients with repaired tetralogy of Fallot.

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Left Ventricular Myocardial Contractile Reserve during Exercise Stress in Healthy Adults: A Two-Dimensional Speckle-Tracking Echocardiographic Study

Cited by 33 publications

References 39 publications

A randomised, double‐blind, placebo‐controlled trial of metformin on myocardial efficiency in insulin‐resistant chronic heart failure patients without diabetes

A randomised, double‐blind, placebo‐controlled trial of metformin on myocardial efficiency in insulin‐resistant chronic heart failure patients without diabetes

Myocardial strain assessed by feature tracking cardiac magnetic resonance in patients with a variety of cardiovascular diseases – A comparison with echocardiography

Exercise echocardiography demonstrates potential myocardial damage in patients with repaired tetralogy of Fallot using layer-specific strain analysis

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