Assessment of decreased left ventricular longitudinal deformation in asymptomatic patients with organic mitral regurgitation and preserved ejection fraction using tissue‐tracking mitral annular displacement by speckle‐tracking echocardiography

Abstract

Background Application of speckle‐tracking echocardiography (STE) provides rapid assessment of tissue‐tracking mitral annular displacement (TMAD). We investigated the value of TMAD for the assessment of decreased LV longitudinal deformation in asymptomatic patients with severe or moderate‐to‐severe mitral regurgitation (MR) and preserved LV ejection fraction (LVEF). Methods We retrospectively studied 50 patients with severe or moderate‐to‐severe organic MR and preserved LVEF (>60%) in whom global longitudinal strain (GLS) was successfully measured by STE. TMAD was quickly assessed in the apical four‐chamber view using STE. We calculated the percentage of TMAD to LV length from the midpoint of mitral annulus to the apex at end‐diastolic (%TMAD). The study population was divided into two groups: decreased GLS patients (>−20%; Group A) and preserved GLS patients (≤−20%; Group B). We examined whether %TMAD could be used as a diagnostic factor of decreased GLS. Results %TMAD was significantly lower in Group A than Group B (12.5 ± 0.5 vs 16.8 ± 2.2, P < 0.0001). By univariate logistic regression analysis, %TMAD was a diagnostic factor of decreased GLS. By multiple regression analysis, %TMAD remained an independent diagnostic factor of decreased GLS (Odds ratio [OR] = 4.21, 95% confidence interval [CI] = 1.34–28.94, P < 0.0001). A cutoff value of %TMAD <14.6 had a sensitivity of 94% and specificity of 94% for the presence of decreased GLS. Conclusions Tissue‐tracking mitral annular displacement is useful in the assessment of decreased LV longitudinal deformation in asymptomatic patients with severe or moderate‐to‐severe MR and preserved LVEF.

Evaluation of left ventricular systolic function in patients with acute ST segment elevation myocardial infarction treated by Tongxinluo after percutaneous coronary intervention by tissue mitral annulus displacement technique

“…Thus, both GLS and GCS can re ect the recovery of left ventricular systolic function in patients with acute STEMI after PCI plus Tongxinluo treatment. GLS can more sensitively re ect changes in left ventricular systolic function than GCS and LVEF, which is consistent with the results of Teraguchi I, et al [20]. This may be because the inner myocardium is more sensitive to myocardial injury, it is located at the distal end of the coronary artery, with abundant microvessels and less effective collateral circulation, and the longitudinal myocardium is easily damaged after PCI [21].…”

Left Ventricular End Diastolic Loading: Comparison of Cardiac MR with Echocardiography

“…Not every parameter was reported on every patient's echocardiogram, hence the differing total numbers of patients for E/A and E/e' in our data. E/A and E/e' ratio can be abnormal when elevated or low [32]. In particular, E/A can be either increased or decreased depending on the type of diastolic dysfunction.…”

Rapid, Single‐View Speckle‐Tracking–Based Method for Examining Left Ventricular Systolic and Diastolic Function in Point of Care Ultrasound

“…An association of TMAD with hard clinical outcomes, for which none of these studies was powered, was ambiguous . When the required times were measured, these were generally less than 15 seconds per echocardiographic view . Buss et al also examined lower‐quality images and found that in patients with reduced image quality (n = 67), TMAD acquisition could be performed more often than strain imaging (67 versus 43; P < .001).…”

“…With speckle-tracking echocardiography (STE), software-based technology has emerged that quantifies myocardial deformation on the basis of 2D image loops. 31 In particular, speckle-tracking-based measurements of longitudinal LV [32][33][34][35][36][37][38][39][40][41] or even right ventricular (RV) 34,35,42 annular motion seem promising. However, many speckle-tracking-based measures require clear visualization of the endocardial border, and image quality is a main factor limiting their utility, particularly in point-of-care settings.…”

“…However, many speckle-tracking-based measures require clear visualization of the endocardial border, and image quality is a main factor limiting their utility, particularly in point-of-care settings. 43,44 Unlike global strain or the strain rate, displacement of the mitral annulus by speckle tracking is rapid 33,38 and does not require superb images. 33,35 Recently we published a novel speckle-trackingbased method for assessing tricuspid annular velocities in anesthetized ventilated patients.…”