Polar plot maps by parametric strain echocardiography allow accurate evaluation of non-viable transmural scar tissue in ischaemic heart disease

Mele, Donato; Fiorencis, Andrea; Chiodi, Elisabetta; Gardini, Chiara; Benea, Giorgio; Ferrari, Roberto

doi:10.1093/ehjci/jev191

Cited by 21 publications

(15 citation statements)

References 19 publications

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“…Our group[7] has recently shown that the SAS area obtained acutely from 2D-STE is related to the CMR transmural scar size 6 months after the acute MI. It, therefore, has the potential to predict development of LVR.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, the size of the SAS area is primarily an expression of the severely dysfunctioning nonviable myocardium. [7]…”

Section: Discussionmentioning

confidence: 99%

“…The area of SAS was contoured and expressed as a percentage of the total myocardial area as described in a previous investigation. [7] The GLS was determined by averaging all peak systolic segmental strain values from the 3 standard apical views. Longitudinal peak strain values were averaged over 2 consecutive cardiac cycles.…”

Section: Methodsmentioning

confidence: 99%

“…[7] For this reason, this area has the potential to predict LVR if applied early in the acute phase of STEMI. Therefore, the purpose of this study was to evaluate the value of the LV SAS area in predicting LVR after STEMI and also to compare it with other echocardiographic and CMR predictors of LVR.…”

Section: Introductionmentioning

confidence: 99%

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Early speckle-tracking echocardiography predicts left ventricle remodeling after acute st-segment elevation myocardial infarction

Mele

Nardozza

Chiodi

2017

J Cardiovasc Echography

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Background:Prediction of the left ventricular remodeling (LVR) after ST-segment elevation myocardial infarction (STEMI) in patients treated with effective myocardial reperfusion is challenging.Methods:Forty-one consecutive patients (36 males, age 59 ± 10 years) with STEMI who underwent effective (TIMI III) primary coronary angioplasty were enrolled. All patients had an echocardiography and cardiac magnetic resonance (CMR) study within 72 h from revascularization. Three echocardiographic parameters including LV ejection fraction (EF), global longitudinal strain (GLS) and severe altered longitudinal strain (SAS) area by two-dimensional speckle-tracking echocardiography (2D-STE) and 3 CMR indices including LV global function index (LV-GFI), myocardial salvage index (MSI), and microvascular obstruction (MVO) were calculated. LVR was defined as an increase in CMR LV end-diastolic volume (EDV) >15% after 6 months.Results:Of 41 patients, 10 (24%) had LVR (LV-EDV from 145.1 ± 29.3 to 185.9 ± 49.8 ml, P < 0.001). A significant correlation with LV-EDV variation was found for baseline SAS area (r = 0.81), LV-GFI (r = −0.56), MVO (r = 0.55), EF (r = −0.42), GLS (r = 0.42), not for MSI (r = −0.25). At the multivariable analysis, a significant correlation remained only for the SAS area. The receiver-operating characteristic curve analysis showed that a baseline SAS area ≥15% predicts LVR with a sensitivity of 80.0% and a specificity of 90.3%.Conclusions:The SAS area evaluated by 2D-STE early in acute STEMI is a valuable predictor of LVR after 6 months. Further investigations are needed to verify its value in predicting patient survival.

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Section: Discussionmentioning

confidence: 99%

“…Conversely, the size of the SAS area is primarily an expression of the severely dysfunctioning nonviable myocardium. [7]…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early speckle-tracking echocardiography predicts left ventricle remodeling after acute st-segment elevation myocardial infarction

Mele

Nardozza

Chiodi

2017

J Cardiovasc Echography

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“…A wide variety of data input sources have been used to create such plots, including echo strain mapping, SPECT imaging, and cardiac magnetic resonance imaging [1, 2]. By resolving different data sources onto a single spatial domain, direct comparisons between substrate analysis techniques for the left ventricle become possible [3].…”

Section: Introductionmentioning

confidence: 99%

Standardized unfold mapping: a technique to permit left atrial regional data display and analysis

Williams

Tobon-Gómez

Zuluaga

et al. 2017

J Interv Card Electrophysiol

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PurposeLeft atrial arrhythmia substrate assessment can involve multiple imaging and electrical modalities, but visual analysis of data on 3D surfaces is time-consuming and suffers from limited reproducibility. Unfold maps (e.g., the left ventricular bull’s eye plot) allow 2D visualization, facilitate multimodal data representation, and provide a common reference space for inter-subject comparison. The aim of this work is to develop a method for automatic representation of multimodal information on a left atrial standardized unfold map (LA-SUM).MethodsThe LA-SUM technique was developed and validated using 18 electroanatomic mapping (EAM) LA geometries before being applied to ten cardiac magnetic resonance/EAM paired geometries. The LA-SUM was defined as an unfold template of an average LA mesh, and registration of clinical data to this mesh facilitated creation of new LA-SUMs by surface parameterization.ResultsThe LA-SUM represents 24 LA regions on a flattened surface. Intra-observer variability of LA-SUMs for both EAM and CMR datasets was minimal; root-mean square difference of 0.008 ± 0.010 and 0.007 ± 0.005 ms (local activation time maps), 0.068 ± 0.063 gs (force-time integral maps), and 0.031 ± 0.026 (CMR LGE signal intensity maps). Following validation, LA-SUMs were used for automatic quantification of post-ablation scar formation using CMR imaging, demonstrating a weak but significant relationship between ablation force-time integral and scar coverage (R 2 = 0.18, P < 0.0001).ConclusionsThe proposed LA-SUM displays an integrated unfold map for multimodal information. The method is applicable to any LA surface, including those derived from imaging and EAM systems. The LA-SUM would facilitate standardization of future research studies involving segmental analysis of the LA.Electronic supplementary materialThe online version of this article (10.1007/s10840-017-0281-3) contains supplementary material, which is available to authorized users.

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Cardiac resynchronization therapy guided by multimodality cardiac imaging

Bertini

Mele

Malagù

et al. 2016

European J of Heart Fail

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Polar plot maps by parametric strain echocardiography allow accurate evaluation of non-viable transmural scar tissue in ischaemic heart disease

Abstract: 2D-STE polar plots of LV longitudinal strain characterize transmural scar tissue accurately compared with MRI and may facilitate its assessment in clinical practice.

Cited by 21 publications

References 19 publications

Early speckle-tracking echocardiography predicts left ventricle remodeling after acute st-segment elevation myocardial infarction

Early speckle-tracking echocardiography predicts left ventricle remodeling after acute st-segment elevation myocardial infarction

Standardized unfold mapping: a technique to permit left atrial regional data display and analysis

Cardiac resynchronization therapy guided by multimodality cardiac imaging

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