Left ventricular strain values using 3D speckle-tracking echocardiography in healthy adults aged 20 to 72 years

Mutluer, Ferit Onur; Bowen, Daniel J.; Grootel, Roderick W. J. van; Roos‐Hesselink, Jolien W.; Bosch, Annemien E. van den

doi:10.1007/s10554-020-02100-3

Cited by 12 publications

(7 citation statements)

References 25 publications

(46 reference statements)

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“…Measurements and normative values are vendor specific, and often only established in adult age ranges. Normative LV strain values are reported via 2-D TomTec CPA in healthy young adults in Mutluer et al, though normative pediatric strain values using TomTec CPA are only reported in smaller cohorts [ 31 – 33 ]. The lack of large pediatric datasets for strain using TomTec CPA specifically prompted our use of an age and gender matched control group to allow for the most accurate comparison, avoiding inter-vendor and inter-reader variability.…”

Section: Discussionmentioning

confidence: 99%

Clinical Predictors of Subacute Myocardial Dysfunction in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

et al. 2022

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Multisystem Inflammatory Syndrome in Children (MIS-C) often involves a post-viral myocarditis and associated left ventricular dysfunction. We aimed to assess myocardial function by strain echocardiography after hospital discharge and to identify risk factors for subacute myocardial dysfunction. We conducted a retrospective single-center study of MIS-C patients admitted between 03/2020 and 03/2021. Global longitudinal strain (GLS), 4-chamber longitudinal strain (4C-LS), mid-ventricular circumferential strain (CS), and left atrial strain (LAS) were measured on echocardiograms performed 3–10 weeks after discharge and compared with controls. Among 60 MIS-C patients, hypotension (65%), ICU admission (57%), and vasopressor support (45%) were common, with no mortality. LVEF was abnormal (< 55%) in 29% during hospitalization but only 4% at follow-up. Follow-up strain abnormalities were prevalent (GLS abnormal in 13%, 4C-LS in 18%, CS in 16%, LAS in 5%). Hypotension, ICU admission, ICU and hospital length of stay, and any LVEF < 55% during hospitalization were factors associated with lower strain at follow-up. Higher peak C-reactive protein (CRP) was associated with hypotension, ICU admission, total ICU days, and with lower follow-up GLS ( r = − 0.55; p = 0.01) and CS ( r = 0.41; p = 0.02). Peak CRP < 18 mg/dL had negative predictive values of 100% and 88% for normal follow-up GLS and CS, respectively. A subset of MIS-C patients demonstrate subclinical systolic and diastolic function abnormalities at subacute follow-up. Peak CRP during hospitalization may be a useful marker for outpatient cardiac risk stratification. MIS-C patients with hypotension, ICU admission, any LVEF < 55% during hospitalization, or a peak CRP > 18 mg/dL may warrant closer monitoring than those without these risk factors.

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Section: Discussionmentioning

confidence: 99%

Clinical Predictors of Subacute Myocardial Dysfunction in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

et al. 2022

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“…To be able to compare the LAS and LASR data, we used a control group consisting of self-declared healthy volunteers, described previously. 11 …”

Section: Methodsmentioning

confidence: 99%

Prognostic value of left atrial strain in patients with congenital aortic stenosis

Mutluer

Bowen

Grootel

et al. 2022

European Heart Journal Open

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Aim To explore whether left atrial (LA) strain with speckle tracking echocardiography (STE) can contribute to prognostication in patients with congenital aortic stenosis (CAS). Methods In this prospective study, consecutive outpatients with stable CAS and healthy adults were enrolled between 2011-2015. LA function was analyzed with STE using Tomtec software. Associations between LA strain (LAS) measurements and primary composite outcome (any adverse cardiovascular event, hospitalisation or reintervention) and secondary outcome (reinterventions) were assessed with Cox regression analysis. Results In total, 98 patients with CAS (mean age: 35.0 ± 11.9y, female: 59.2%) and 121 controls (Age: 43.9 ± 13.8y, female: 55.4%) were included. The majority of patients were in NYHA class I: 97 (99%) at baseline. At baseline, LA conduit strain (LAS-cd) and strain rate (LASR-cd) were significantly lower in patients compared to controls when corrected for age and sex (-18.1 ± 8.7 versus -23.5 ± 9.9%, p = 0.001 and -0.73 ± 0.31 versus -1.02 ± 0.43/s, p < 0.001). During a median follow-up of 6.4 years (5.7-7.1), the primary composite outcome occurred in 48 (39.6%) patients. Kaplan Meier analysis showed that decreased LA conduit strain (<21%) was associated with a higher occurrence of the primary outcome (log-rank: p = 0.008). Depressed LAS-cd and LASR-cd were both associated with the primary composite outcome (univariable HR = 0.64[0.46-0.88], p = 0.005 and HR = 0.68[0.55-0.83], p < 0.001 respectively); adjusted HR (for LAS-cd and LASR-cd, respectively): 0.31(0.09-1.04), p = 0.06 and 0.49(0.26-0.89), p = 0.02. Conclusion Impairment in LA conduit function assessed with STE carries prognostic value in patients with CAS and can be implemented in clinical management.

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“…[13] The de nitions of LA strain, strain rate and volume are summarized in Supplementary table 1. Normative ranges for LA-S [13], LV-GLS [14], LV-SRe [15], and RV-FWLS [16] were extracted from the studies conducted in the same hospital.…”

Section: Speckle Tracking Analysismentioning

confidence: 99%

Prognostic value of left atrial strain in patients with Tetralogy of Fallot

Mutluer

Bowen

Grootel

et al. 2023

Preprint

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PURPOSE: To demonstrate prognostic utility of left atrial strain(LAS) in adult patients with repaired Tetralogy of Fallot(rTOF). METHODS: Adults patients with rTOF were prospectively enrolled in this study between years 2011-2015. Left atrium(LA) phasic functions were assessed using 2D speckle tracking echocardiography(2D-STE). Association of LA strain(LAS) with primary(any cardiovascular event) and secondary(death, heart failure or arrhythmia) composite endpoints was assessed using Cox regression analysis. RESULTS: Hundred-and-twelve rTOF patients, in whom LAS was feasible and were in sinus rhythm, were included in the final analysis (age 33±10 years, 68[61%] male). Median duration of follow-up was 8.6[4.2-9.7] years in the study group. Primary composite endpoint was reached in 48 patients (mean event-free survival time: 7.2[6.6-7.9] years), and secondary composite endpoint was reached in 22 patients (mean event-free survival time: 8.7[8.1-9.2] years). LAS-r was defined as tertile groups(1st tertile<33 %,2nd tertile=33-44%,3rd tertile>44%). Decreasing tertiles of LAS-r was associated with primary and secondary composite endpoints in Kaplan-Meier analysis(p=0.02 and 0.002, respectively). In univariable Cox-regression, both decreasing LAS-r and LAS-r tertiles were associated with primary and secondary composite endpoints. Adjusted by initial repair age and NT-proBNP quartiles, increased LAS-r was associated with significantly decreased occurrence of experiencing any events(HR=0.97,CI:0.93-0.99,p=0.037]). Decreasing LAS-r was still associated with primary endpoint when adjusted by left atrium volume index(LAVImax)(HR=0.96,CI:0.03-0.99,p=0.01),left ventricle global longitudinal strain(LV-GLS)(0.95,95%CI:0.92-0.98,p=0.002) or right ventricle free wall longitudinal strain (RV-FWLS)(0.96,95%CI:0.93-0.99,p=0.04). CONCLUSION: Assessment of LA mechanics with the use of STE has incremental utility in determination of mortality and morbidity in rTOF, and may be implemented in clinical practice.

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Left ventricular strain values using 3D speckle-tracking echocardiography in healthy adults aged 20 to 72 years

Cited by 12 publications

References 25 publications

Clinical Predictors of Subacute Myocardial Dysfunction in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

Clinical Predictors of Subacute Myocardial Dysfunction in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

Prognostic value of left atrial strain in patients with congenital aortic stenosis

Prognostic value of left atrial strain in patients with Tetralogy of Fallot

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