Speckle tracking echocardiography in early disease stages: a therapy modifier?

Mandoli, Giulia Elena; Cameli, Matteo; Pastore, María; Benfari, Giovanni; Malagoli, Alessandro; D’Andrea, Antonello; Sperlongano, Simona; Bandera, Francesco; Esposito, Roberta; Santoro, Ciro; Pedrinelli, Roberto; Mercuro, Giuseppe; Indolfi, Ciro

doi:10.2459/jcm.0000000000001422

Cited by 3 publications

(3 citation statements)

References 137 publications

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“…This study enriches literature data through the identification of referral values of longitudinal, global and segmental strain for both ventricles in premature newborns, with gestational ages ranging between 28 and 36 weeks. The establishment of referral values for speckle tracking measurements can aid in a better understanding of the transitional physiology of myocardial function in premature newborns ( 1 ) and could aid in the premature identification of subclinical cardiac dysfunction ( 3 ). Moreover, the discovery of a better response of the right ventricle to the longitudinal deformation in premature neonates, as opposed to term newborns, enables the knowledge of accurate reference values for this particular population segment, which will create the premises for the evaluation of ventricular function in premature newborns with concurring disorders.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac ultrasonography remains one of the important non-invasive tools which assesses myocardial function and can simultaneously offer data for the proper management of the hemodynamically instable newborn, as well as information related to the monitoring of their evolution and prognosis. Advanced cardiac ultrasound techniques such as the analysis of myocardial deformation through speckle tracking (STE) have been proven to be superior to conventional measurements of myocardial function, in terms of identifying myocardial disfunction, characterizing myocardial phenotype and guiding treatment ( 3 , 4 ). Reference intervals for myocardial deformation are mostly found in term newborns and extremely premature newborns, with scarce data available in mid to late premature newborns.…”

Section: Introductionmentioning

confidence: 99%

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Comparative assessment of myocardial function between late premature newborns and term neonates using the 2D speckle tracking method

Toma,

Făgărășan,

Cerghit-Paler

et al. 2024

Front. Pediatr.

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IntroductionAssessment of myocardial function through speckle tracking echocardiography (STE) can bring benefits to conventional echocardiography in premature newborns, a particular vulnerable group in terms of adaptation to extra-uterine life. Furthermore, it represents a non-invasive imagistic method which can guide therapeutic approach in the hemodynamically unstable newborn. This study aims to highlight the particularities of myocardial function in late premature newborns, by conducting a comparison with a group of healthy neonates, by using STE.MethodsConducted over a timespan of two years, this prospective study enrolled 64 term neonates and 21 premature newborns, with gestational ages ranging between 28 and 36 weeks, who prior to discharge underwent a cardiac ultrasound, involving two-dimensional image acquisitions of the apical four-chamber view of both ventricles. Afterwards, the images were offline analyzed, by using the autostrain function.ResultsAfter segmental strain analysis, no significant discrepancies between the two groups in terms of interventricular values were found. However, left ventricle and right ventricle strain measurements differed significantly (p < 0.01), for each of the analyzed segments (basal, medial or apical). Moreover, a linear increase in interventricular (IV) basal strain with corrected gestational age progression was noted (p = 0.04). Peak global longitudinal strain (pGLS) and EF were similar between the two study groups. Premature newborns presented significantly more negative mean values of right ventricular free wall longitudinal strain (RVFWSL), (−24.19 ± 4.95 vs. −18.05 ± 5.88, p < 0.01) and of right ventricle global four chamber longitudinal strain (RV4CSL), (−19.71 ± 3.62 vs. −15.46 ± 5.59, p < 0.01), when compared to term neonates.ConclusionsThe 2D STE is a reliable method for cardiac assessment of late preterm newborns. The evaluation of two-dimensional global longitudinal LV and RV strains might represent a useful tool in clinical practice. A better response of the right ventricle to the longitudinal deformation within premature neonates was noted. Thus, this study facilitates the identification of accurate reference values for this particular population segment, which will enable the evaluation of ventricular function in premature newborns with concurring disorders. Future longitudinal studies, assessing the fetal heart, could provide more insight into the development of myocardial function.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative assessment of myocardial function between late premature newborns and term neonates using the 2D speckle tracking method

Toma,

Făgărășan,

Cerghit-Paler

et al. 2024

Front. Pediatr.

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“…Thus, speckle-tracking echocardiography (STE) plays a very important role in differentiating cardiac amyloidosis from other types of left-ventricular hypertrophy [17,18]. In fact, in patients with cardiac amyloidosis, the longitudinal strain is more reduced in the basal segments compared to the apical ones (apical sparing).…”

Section: Introductionmentioning

confidence: 99%

Hereditary Transthyretin Amyloidosis: How to Differentiate Carriers and Patients Using Speckle-Tracking Echocardiography

Di Lisi,

Brighina,

Manno

et al. 2023

Diagnostics

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Background: Hereditary transthyretin amyloidosis is a rare disease caused by transthyretin (TTR) gene mutations. The aim of our study was to identify early signs of cardiac involvement in patients with a TTR gene mutation in order to differentiate carriers from patients with neurological or cardiac disease. Methods: A case–control study was carried out on 31 subjects with the TTR mutation. Patients were divided into three groups: 23% with cardiac amyloidosis and polyneuropathy (group A), 42% with only polyneuropathy (group B) and 35% carriers (group C). Speckle-tracking echocardiography (left-ventricular global longitudinal strain—GLS, atrial stiffness) was performed in all patients. The apical/basal longitudinal strain ratio (SAB) and relative apical sparing (RAS) were assessed in all subjects. Results: Analyzing groups C and B, we only found a significant difference in the SAB (p-value 0.001) and RAS (p-value 0.039). These parameters were significantly more impaired in group A compared to group B (SAB p-value 0.008; RAS p-value 0.002). Also, atrial stiffness was significantly impaired in groups A and B compared to group C. Conclusions: Our study suggests the diagnostic role of the SAB and RAS in cardiac amyloidosis. The SAB and RAS showed a gradual increase from carriers to patients with neurological and cardiac diseases. Thus, these parameters, in addition to atrial stiffness, could be used to monitor carriers. More extensive data are needed.

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Use of speckle tracking echocardiography in evaluating cardiac dysfunction in patients with acromegaly: an update

Huang,

Jin,

Zhang

et al. 2023

Front. Endocrinol.

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In recent years, cardiovascular disease has garnered increasing attention as the second leading cause of death in individuals with acromegaly, following malignancy. Identifying cardiac dysfunction early in acromegaly patients for timely intervention has become a focal point of clinical research. Speckle tracking echocardiography, a well-established ultrasound technique, surpasses conventional Doppler ultrasound in its sensitivity to assess both local and global cardiac mechanics. It can accurately detect subclinical and clinical myocardial dysfunction, including myocardial ischemia, ventricular hypertrophy, and valvular changes. Over the past five years, the use of speckle tracking echocardiography in acromegaly patients has emerged as a novel approach. Throughout the cardiac cycle, speckle tracking echocardiography offers a sensitive evaluation of the global and regional myocardial condition by quantifying the motion of myocardial fibres in distinct segments. It achieves this independently of variations in ultrasound angle and distance, effectively simulating the deformation of individual ventricles across different spatial planes. This approach provides a more accurate description of changes in cardiac strain parameters. Importantly, even in the subclinical stage when ejection fraction remains normal, the strain parameters assessed by speckle tracking echocardiography hold a good predictive value for the risk of cardiovascular death and hospitalization in acromegaly patients with concomitant cardiovascular disease. This information aids in determining the optimal timing for interventional therapy, offering important insights for cardiac risk stratification and prognosis. In the present study, we comprehensively reviewed the research progress of speckle tracking echocardiography in evaluating of cardiac dysfunction in acromegaly patients, to pave the way for early diagnosis of acromegaly cardiomyopathy.

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Speckle tracking echocardiography in early disease stages: a therapy modifier?

Cited by 3 publications

References 137 publications

Comparative assessment of myocardial function between late premature newborns and term neonates using the 2D speckle tracking method

Comparative assessment of myocardial function between late premature newborns and term neonates using the 2D speckle tracking method

Hereditary Transthyretin Amyloidosis: How to Differentiate Carriers and Patients Using Speckle-Tracking Echocardiography

Use of speckle tracking echocardiography in evaluating cardiac dysfunction in patients with acromegaly: an update

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