Selective echocardiographic analysis of epicardial and endocardial left ventricular rotational mechanics in an animal model of pericardial adhesions

Alharthi, Mohsen; Jiamsripong, Panupong; Calleja, Anna; Sengupta, Partho P.; McMahon, Eileen; Khandheria, Bijoy K.; Tajik, A. Jamil; Bělohlávek, Marek

doi:10.1093/ejechocard/jen338

Cited by 30 publications

(28 citation statements)

References 28 publications

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“…Indeed, in a previous experimental model of pericardial adhesion, we demonstrated that myocardial motion is reduced because of pericardial adhesions over the epicardial surface; however, the epi-to-endocardial gradient of myocardial function remained unaltered, suggesting that endocardial shortening proceeds relatively normally despite the process of epicardial adhesions. 42 Our results suggest that the pericardial-myocardial functional relationships are more complex, and that a constrictive pericardium may alter myocardial function differentially in the myocardial layers. Perhaps with improved spatial resolution, in the near future, investigations could be undertaken to resolve the transmural gradient of strains in patients with CP and RCM.…”

Section: Myocardial Deformation In Cp and Rcmmentioning

confidence: 70%

Diagnostic Concordance of Echocardiography and Cardiac Magnetic Resonance–Based Tissue Tracking for Differentiating Constrictive Pericarditis From Restrictive Cardiomyopathy

Amaki

Savino

Ain

et al. 2014

Circ: Cardiovascular Imaging

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Background-Variations in longitudinal deformation of the left ventricle have been suggested to be useful for differentiating chronic constrictive pericarditis (CP) and restrictive cardiomyopathy (RCM). We assessed left ventricular mechanics derived from cardiac magnetic resonance (CMR) cine-based and 2-dimensional echocardiography-based tissue tracking to determine intermodality consistency of diagnostic information for differentiating CP from RCM. Methods and Results-We retrospectively identified 92 patients who underwent both CMR and 2-dimensional echocardiography and who had a final diagnosis of CP (n=28), RCM (n=30), or no structural heart disease (n=34). Global longitudinal strain from long-axis views and circumferential strain from short-axis views were measured on 2-dimensional echocardiographic and CMR cine images using the same offline software. Logistic regression models with receiver operating characteristics curves, continuous net reclassification improvement, and the integrated discrimination improvement (IDI) were used for assessing the incremental predictive performance. Global longitudinal strain was higher in patients with CP than in those with RCM (P<0.001), and both techniques were found to have similar diagnostic value (area under the curve, 0.84 versus 0.88 for CMR and echocardiography, respectively). For echocardiography, the addition of global longitudinal strain to respiratory septal shift and early diastolic mitral annular velocity resulted in improved continuous net reclassification improvement (P<0.001 for both) and integrated discrimination improvement (P=0.005 and 0.024) for both models. Similarly, for CMR, the addition of global longitudinal strain to septal shift and pericardial thickness resulted in improved continuous net reclassification improvement (P<0.001 for both) and integrated discrimination improvement (P=0.003 and <0.001). Makoto Amaki, MD, PhD; John Savino, MD; David L. Ain, MD; Javier Sanz, MD; Gianni Pedrizzetti, PhD; Hemant Kulkarni, MD; Jagat Narula, MD, PhD; Partho P. Sengupta, MD Pericardial Disease D ifferentiating constrictive pericarditis (CP) from restrictive cardiomyopathy (RCM) in patients with right heart failure can be a challenge. Cardiac catheterization, although often performed for hemodynamic confirmation, may not always be conclusive. 1,2 This has led to continued interest in other diagnostic modalities. Several echocardiographic measurements have been proposed to differentiate myocardial diseases from pericardial constriction. Conclusions-CMR3,4 Cardiac magnetic resonance (CMR) imaging has superior contrast-to-noise and signal-tonoise ratios, permitting accurate quantification of pericardial thickening and providing assessment of the entire thorax. 5Because noninvasive imaging techniques continue to advance, the clinical differentiation of CP from RCM is based on the recognition of a cluster of structural, mechanical, and hemodynamic aberrations rather than a single structural or functional variable used in isolation. Specifically the recent growth i...

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Section: Myocardial Deformation In Cp and Rcmmentioning

confidence: 70%

Diagnostic Concordance of Echocardiography and Cardiac Magnetic Resonance–Based Tissue Tracking for Differentiating Constrictive Pericarditis From Restrictive Cardiomyopathy

Amaki

Savino

Ain

et al. 2014

Circ: Cardiovascular Imaging

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“…LV twist is defined as the maximal instantaneous difference between the apical and basal rotations. LV torsion is defined for the purpose of this study as LV twist magnitude normalized to LV length 4)14)…”

Section: Methodsmentioning

confidence: 99%

“…LV rotation plays an important role in maintaining efficient myocardial contraction during systole and aids in generating early suction power during the isovolumic relaxation period 2)3). Assessment of rotation may provide important insights into different types of myocardial dysfunction and the effect of different treatment strategies 4-9). Recent technological advances in echocardiography such as velocity vector imaging allows for the quantification of myocardial mechanics including rotation, twist and torsion.…”

Section: Introductionmentioning

confidence: 99%

Left Ventricular Torsion Changes Post Kidney Transplantation

Deng

Pandit

Heilman

et al. 2013

J Cardiovasc Ultrasound

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BackgroundTo quantify changes of left ventricular (LV) torsion in patients' pre and post kidney transplantation.MethodsA prospective study was conducted on 48 patients who received kidney transplantation for end stage renal disease and without myocardial infarction. The rotation, twist and torsion of LV were studied pre and post kidney transplantation (6 months post transplantation) using velocity vector imaging by echocardiography. The data is expressed as mean ± standard deviation and compared by paired t-test at the p < 0.05 significance level.ResultsSix months post kidney transplantation, left ventricular ejection fraction (from 40.33 ± 11.42 to 61.00 ± 13.68%), ratio of mitral early and late diastolic filling velocity (from 1.04 ± 0.57 to 1.21 ± 0.52), rotation of basal LV (from 4.48 ± 2.66 to 5.65 ± 2.64 degree), rotation of apical LV (from 4.27 ± 3.08 to 5.50 ± 4.25 degree), LV twist (8.75 ± 4.45 to 11.14 ± 5.25 degree) and torsion (from 1.06 ± 0.54 to 1.33 ± 0.61 degree/cm) were increased significantly (p < 0.05). Interventricular septum thickness (from 11.67 ± 2.39 to 9.67 ± 0.48 mm), left ventricular mass index (from 104.00 ± 16.47 to 95.50 ± 21.44 g/m2), systolic blood pressure (from 143.50 ± 34.99 to 121.50 ± 7.09 mmHg), serum blood urea nitrogen (from 42.40 ± 7.98 to 30.43 ± 13.85 mg/dL) and creatinine (from 4.53 ± 1.96 to 2.73 ± 2.57 mg/dL) were decreased significantly (p < 0.05).ConclusionKidney transplantation in end stage renal disease without myocardial infarction results in improvement in left ventricular structure, function and myocardial mechanics as detected by echocardiography and velocity vector imaging. Velocity vector imaging provided valuable information for detection and follow-up of cardiac abnormalities in patients with end stage renal disease.

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“…According to the earlier studies, pericardium has been suggested to have a possible role in the interventricular interaction,3 although pericardial opening does not significantly affect the LV systolic and diastolic function in clinical situation 4 5. Other researchers suggested that a well-lubricated pericardium is important for normal twist,18 but they did not provide the data about the change of LV twist without pericardium. However, a recent study by Tanaka et al using 2D speckle tracking echocardiography showed that pericardial defects observed in patients with congenital total absence of pericardium leads to a lack of LV twist compared with normal controls 6.…”

Section: Discussionmentioning

confidence: 99%