Longitudinal strain combined with delayed-enhancement magnetic resonance improves risk stratification in patients with dilated cardiomyopathy

Chimura, Misato; Onishi, Tetsuari; Tsukishiro, Yasue; Sawada, Takahiro; Kiuchi, Kunihiko; Shimane, Akira; Okajima, Katsunori; Yamada, Shinichiro; Taniguchi, Yoshinori; Yasaka, Yoshinori; Kawai, Hiroya

doi:10.1136/heartjnl-2016-309746

Cited by 56 publications

(41 citation statements)

References 35 publications

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“…Global longitudinal strain. GLS is an early and sensitive marker of LV functional decline over a wide range of diseases (15)(16)(17). In cancer patients receiving chemotherapy, an early LVEDD and LVESD: Left ventricular end-diastolic and end-systolic diamerters, respectively; LV: left ventricular; RV: right ventricular; LVEF: left ventricular ejection fraction; TAPSE: tricuspid annular plane systolic excursion; LAVI: left atrial volume indexed to body surface area; Mitral E, dt, Ea and Ee': Mitral inflow early diastolic velocity, declaration time of the early inflow, the ratio between early inflow and late inflow velocities and the ratio between early mitral inflow velocity and averaged pulsed tissue Doppler early diastolic velocities derived from basal anterior, septal, posterior and lateral LV walls, respectively; IVC and cIVC: inferior vena cava maximal diameter and its variation, respectively.…”

Section: Changes In Apical Strain In the Follow-up According To Brementioning

confidence: 99%

Left Ventricular Speckle Tracking Echocardiography Changes Among Early-stage Breast Cancer Patients Three Years After Radiotherapy

et al. 2019

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Background/Aim: Chest radiotherapy (RT) doubles late cardiac mortality. This study aimed to evaluate the evolution of cardiac changes in speckle tracking echocardiography during a three-year follow-up. Materials and Methods: This prospective study included 81 chemotherapy-naïve early-stage breast cancer patients who were evaluated at baseline, immediately after RT and three years after RT. Sixty-one patients had left-sided (LSBC) and 20 right-sided breast cancer (RSBC). Results: Global longitudinal strain (GLS) declined from baseline-18.0±3.3% to-17.0±3.0% (p=0.015) at the three-year follow-up examination. A decline over 15% (GLS15) was observed in 19 (27%) patients. GLS15 was independently associated with aromatase inhibitor use (β=-1.977, p=0.001). In regional analysis, patients with LSBC had apical strain decline by 3.2±5.5% (p<0.001) and patients with RSBC showed basal rotation decline by 1.8˚ (-0.2˚, 3.8˚) (p=0.030). Conclusion: Even contemporary RT induced progressive global and regional decline in speckle tracking analysis. The regional changes complied with RT fields. Radiotherapy (RT) is an integral part of the treatment in half of cancer patients (1). Over 80% of early-stage breast cancer patients receive adjuvant RT, which reduces the local recurrence risk by half and, the late breast cancer-related mortality by a fifth. The overall survival of early-stage breast cancer patients at 5 years is 91% in Finland (www.cancerregistry.fi). However, RT induces adverse effects in healthy tissue, which may lead to late dysfunction in adjacent organs. The heart is an important organ at risk, especially in left-sided breast cancer (LSBC). Breast cancer RT increases cardiac mortality and morbidity almost twofold in long-term cohorts collected from patients treated with older RT techniques (2, 3). The modern RT treatment protocols have reduced cardiac radiation exposure. However, the clinical impact of the reduced cardiac dose will not be revealed until long-term data are available. In the meantime, early and mid-term cardiac changes are valuable in predicting later sequelae and to reveal the mechanism and time-course of RT-induced heart disease (RIDH). RIHD can manifest as coronary artery disease, valvular lesions, heart failure, pericardial changes or conduction abnormalities. These changes occur usually several years or decades after RT treatment (2-4). The early subclinical RTinduced cardiac changes precede the late manifestations. Perfusion defects and changes in strain and strain rate corresponding to the RT fields have been detected 0-6 months after RT with myocardial perfusion imaging and with echocardiography (5-7). After chemotherapy, an early change in global longitudinal strain (GLS) predicts later decline in left ventricular ejection fraction (LVEF), but the knowledge of post-RT strain evolution is sparse (8, 9). The aim of our study was to explore the evolution of early RT-induced changes in speckle tracking echocardiography (STE) in early-stage breast cancer patients within the first three years after ...

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Section: Changes In Apical Strain In the Follow-up According To Brementioning

confidence: 99%

Left Ventricular Speckle Tracking Echocardiography Changes Among Early-stage Breast Cancer Patients Three Years After Radiotherapy

et al. 2019

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“…It has been widely reported that GLS in conjunction with HF stage classification is more useful for HF patient management than conventional echocardiographic parameters, even in patients with findings other than Stage A HF [13]. The utility of GLS for HF patients is accounted for by its ability to predict independently associated with long-term outcome [30]. They also found that patients with GLS ≥8.3%…”

Section: Discussionmentioning

confidence: 99%

Impact of Diabetes Mellitus on Left Ventricular Longitudinal Function of Patients with Non-Ischemic Dilated Cardiomyopathy

Tanaka

Tatsumi

Matsuzoe

et al. 2020

Preprint

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Background Left ventricular (LV) longitudinal dysfunction has been identified in type 2 diabetes mellitus (T2DM) patients with preserved LV ejection fraction (LVEF). However, the impact of T2DM on LV longitudinal function or the association of LV longitudinal function with outcome for dilated cardiomyopathy (DCM) remains unclear. Methods We retrospectively studied 206 patients with non-ischemic DCM, mean age of 59 ± 17 years and LVEF of 31 ± 8% (all < 45%). All patients underwent a standard echocardiographic examination, and LV longitudinal function was assessed in terms of global longitudinal strain (GLS). Long-term outcomes were assessed, with a median follow-up period of 6.2 years, as primary endpoints of death from or hospitalization for deteriorating heart failure. Results GLS of DCM patients with T2DM (n = 55) was significantly lower than that in DCM patients without T2DM (n = 151) in spite of similar conventional LV function (7.0 ± 2.0% vs. 7.8 ± 2.2%, p = 0.03). Kaplan-Meier curves indicated that long-term outcomes for DCM patients without T2DM were better than for those with T2DM (log-rank p = 0.001). Subdividing the two groups into four with by using the median value of GLS (7.9%) showed long-term outcome was worst for DCM patients with T2DM and low GLS. Cox proportional hazards analyses demonstrated an independent association of T2DM, GLS and left atrial volume index with long-term outcome. Moreover, multiple regression analysis for the association of GLS showed that T2DM was the independent determinant parameter for GLS as well as for LVEF and left atrial volume index. Conclusion Management of DCM patients with T2DM may be improved by using GLS guidance.

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“…Furthermore, it has been shown that LV longitudinal myocardial function, rather than a global LV function such as LVEF, can be a more accurate marker for detection of subtle changes in LV myocardial function as well as a more accurate prognostic marker. [23][24][25] It was further reported that LV dispersion, which reflects the heterogeneity of timing of regional LV myocardial contraction, plays an important role by serving as a prognostic marker for HF patients independent of LVEF. 26,27 However, what the association is of LV dispersion with LV performance in patients with ASD remains uncertain.…”

Section: Bi-ventricular Interaction In Asd Patients After Asomentioning

confidence: 99%

Left ventricular dispersion as a parameter for augmented left ventricular stroke volume in patients with atrial septal defect following transcatheter closure

et al. 2017

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Longitudinal strain combined with delayed-enhancement magnetic resonance improves risk stratification in patients with dilated cardiomyopathy

Abstract: Combining GLS and LGE could be useful for risk stratification and prognostic assessment in patients with DCM.

Cited by 56 publications

References 35 publications

Left Ventricular Speckle Tracking Echocardiography Changes Among Early-stage Breast Cancer Patients Three Years After Radiotherapy

Left Ventricular Speckle Tracking Echocardiography Changes Among Early-stage Breast Cancer Patients Three Years After Radiotherapy

Impact of Diabetes Mellitus on Left Ventricular Longitudinal Function of Patients with Non-Ischemic Dilated Cardiomyopathy

Left ventricular dispersion as a parameter for augmented left ventricular stroke volume in patients with atrial septal defect following transcatheter closure

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