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Early detection of regional and global left ventricular myocardial function using strain and strain-rate imaging in patients with metabolic syndrome.

Wang Q, Sun QW, Wu D, Yang MW, Li RJ, Jiang B, Yang J, Li ZA, Wang Y, Yang Y - Chin. Med. J. (2015)

Bottom Line: There were no statistically significant differences between MS and controls in all traditional parameters of LV systolic function.On the other hand, significant differences were observed between MS and the control group in most of the parameters of S, SR-s, SR-e in regional LV function.Multiple stepwise regression analyses revealed that S and SR significantly were negatively correlated with blood pressure, waist circumference, fasting plasma glucose, uric acid, suggesting that risk factories were relevant to regional systolic dysfunction.

View Article: PubMed Central - PubMed

Affiliation: Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling Related Cardiovascular Diseases, Ministry of Education, Beijing 100029, China.

ABSTRACT

Background: Strain and strain-rate imaging (SRI) have been found clinically useful in the assessment of cardiac systolic and diastolic function as well as providing new insights in deciphering cardiac physiology and mechanics in cardiomyopathies, and identifying early subclinical changes in various pathologies. The aim of this study was to evaluate the regional and global left ventricular (LV) myocardial function in metabolic syndrome (MS) with SRI so that we can provide more myocardial small lesions in patients with MS, which is robust and reliable basis for early detection of LV function.

Methods: Thirty-nine adults with MS were enrolled in the study. There was a control group of 39 healthy adults. In addition to classic echocardiographic assessment of LV global functional changes, SRI was used to evaluate regional and global LV function. Including: Peak systolic strain (S), peak systolic strain-rate (SR-s), peak diastolic strain-rate (SR-e).

Results: There were no statistically significant differences between MS and controls in all traditional parameters of LV systolic function. On the other hand, significant differences were observed between MS and the control group in most of the parameters of S, SR-s, SR-e in regional LV function. Multiple stepwise regression analyses revealed that S and SR significantly were negatively correlated with blood pressure, waist circumference, fasting plasma glucose, uric acid, suggesting that risk factories were relevant to regional systolic dysfunction.

Conclusion: In MS with normal LV ejection fraction, there was regional myocardial dysfunction, risk factors contributed to the impairment of systolic and diastolic function of the regional myocardium. Assessment of myocardial function using SRI could be more accurate in MS patient evaluation than conventional echocardiography alone.

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Related in: MedlinePlus

Strain and strain-rate imaging from the mid-inferoseptal myocardial segment from a study subject. Peak systolic strain is the peak percentage long-axis shortening; peak systolic strain-rate is the peak rate of shortening; peak diastolic strain-rate is the peak rate of length.
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Figure 2: Strain and strain-rate imaging from the mid-inferoseptal myocardial segment from a study subject. Peak systolic strain is the peak percentage long-axis shortening; peak systolic strain-rate is the peak rate of shortening; peak diastolic strain-rate is the peak rate of length.

Mentions: Myocardial S and SR was derived from TDI. S and SR were derived from S and SR curves[13] obtained by placing a sample bar (10 mm) in the basal and middle segments of the septal, lateral, inferior, anterior and posterior walls from the apical four-chamber [Figure 1], two-chamber and long axis views. S and SR curves were extracted from color TDI by standard software (GE Vingmed). SR data were recorded from the basal and middle segments, using standard apical views at a high frame rate (>100 frames/s). The region of interest [Figure 2] inter-ventricular septum was constant at 5 mm2 during the whole trial and was tracked automatically throughout the systole. The basal and mid-myocardial layer were sampled in each segment and maintained at the same position during the cardiac cycle by manually tracking wall motion [Figure 2], but we excluded data if we were unable to obtain a smooth strain curve or the angle between the scan line and wall was >20°. Peak systolic strain was defined as the greatest value on the strain curve, and peak systolic strain-rate (SR-s) was measured from the strain curve as previously validated. At the same time SR-s, peak early and late diastolic strain-rate (SR-e and SR-a), and peak systolic strain from the same sample volume within the same cardiac cycle. SR data were averaged from 4 to 6 cycles.[14]


Early detection of regional and global left ventricular myocardial function using strain and strain-rate imaging in patients with metabolic syndrome.

Wang Q, Sun QW, Wu D, Yang MW, Li RJ, Jiang B, Yang J, Li ZA, Wang Y, Yang Y - Chin. Med. J. (2015)

Strain and strain-rate imaging from the mid-inferoseptal myocardial segment from a study subject. Peak systolic strain is the peak percentage long-axis shortening; peak systolic strain-rate is the peak rate of shortening; peak diastolic strain-rate is the peak rate of length.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837843&req=5

Figure 2: Strain and strain-rate imaging from the mid-inferoseptal myocardial segment from a study subject. Peak systolic strain is the peak percentage long-axis shortening; peak systolic strain-rate is the peak rate of shortening; peak diastolic strain-rate is the peak rate of length.
Mentions: Myocardial S and SR was derived from TDI. S and SR were derived from S and SR curves[13] obtained by placing a sample bar (10 mm) in the basal and middle segments of the septal, lateral, inferior, anterior and posterior walls from the apical four-chamber [Figure 1], two-chamber and long axis views. S and SR curves were extracted from color TDI by standard software (GE Vingmed). SR data were recorded from the basal and middle segments, using standard apical views at a high frame rate (>100 frames/s). The region of interest [Figure 2] inter-ventricular septum was constant at 5 mm2 during the whole trial and was tracked automatically throughout the systole. The basal and mid-myocardial layer were sampled in each segment and maintained at the same position during the cardiac cycle by manually tracking wall motion [Figure 2], but we excluded data if we were unable to obtain a smooth strain curve or the angle between the scan line and wall was >20°. Peak systolic strain was defined as the greatest value on the strain curve, and peak systolic strain-rate (SR-s) was measured from the strain curve as previously validated. At the same time SR-s, peak early and late diastolic strain-rate (SR-e and SR-a), and peak systolic strain from the same sample volume within the same cardiac cycle. SR data were averaged from 4 to 6 cycles.[14]

Bottom Line: There were no statistically significant differences between MS and controls in all traditional parameters of LV systolic function.On the other hand, significant differences were observed between MS and the control group in most of the parameters of S, SR-s, SR-e in regional LV function.Multiple stepwise regression analyses revealed that S and SR significantly were negatively correlated with blood pressure, waist circumference, fasting plasma glucose, uric acid, suggesting that risk factories were relevant to regional systolic dysfunction.

View Article: PubMed Central - PubMed

Affiliation: Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling Related Cardiovascular Diseases, Ministry of Education, Beijing 100029, China.

ABSTRACT

Background: Strain and strain-rate imaging (SRI) have been found clinically useful in the assessment of cardiac systolic and diastolic function as well as providing new insights in deciphering cardiac physiology and mechanics in cardiomyopathies, and identifying early subclinical changes in various pathologies. The aim of this study was to evaluate the regional and global left ventricular (LV) myocardial function in metabolic syndrome (MS) with SRI so that we can provide more myocardial small lesions in patients with MS, which is robust and reliable basis for early detection of LV function.

Methods: Thirty-nine adults with MS were enrolled in the study. There was a control group of 39 healthy adults. In addition to classic echocardiographic assessment of LV global functional changes, SRI was used to evaluate regional and global LV function. Including: Peak systolic strain (S), peak systolic strain-rate (SR-s), peak diastolic strain-rate (SR-e).

Results: There were no statistically significant differences between MS and controls in all traditional parameters of LV systolic function. On the other hand, significant differences were observed between MS and the control group in most of the parameters of S, SR-s, SR-e in regional LV function. Multiple stepwise regression analyses revealed that S and SR significantly were negatively correlated with blood pressure, waist circumference, fasting plasma glucose, uric acid, suggesting that risk factories were relevant to regional systolic dysfunction.

Conclusion: In MS with normal LV ejection fraction, there was regional myocardial dysfunction, risk factors contributed to the impairment of systolic and diastolic function of the regional myocardium. Assessment of myocardial function using SRI could be more accurate in MS patient evaluation than conventional echocardiography alone.

Show MeSH
Related in: MedlinePlus