Authors:A. Nemes, Z. Kovács, Á. Kormányos, P. Domsik, A. Kalapos, Z. Ajtay and C. Lengyel
Left ventricular (LV) twist is considered an essential part of LV function due to oppositely directed LV basal and apical rotations. Several factors could play a role in determining LV rotational mechanics in normal circumstances. This study aimed to investigate the relationship between LV rotational mechanics and mitral annular (MA) size and function in healthy subjects.
The study comprised 118 healthy adult volunteers (mean age: 31.5 ± 11.8 years, 50 males). All subjects had undergone complete two-dimensional (2D) Doppler echocardiography and three-dimensional speckle-tracking echocardiography (3DSTE) at the same time by the same echocardiography equipment.
The normal mean LV apical and basal rotations proved to be 9.57 ± 3.33 and −3.75 ± 1.98°, respectively. LV apical rotation correlated with end-systolic MA diameter, area, perimeter, fractional area change, and fractional shortening, but did not correlate with any end-diastolic mitral annular morphologic parameters. The logistic regression model identified MA fractional area change as an independent predictor of ≤6° left ventricular apical rotation (P < 0.003).
Correlations could be detected between apical LV rotation and end-systolic MA size and function, suggesting relationships between MA dimensions and function and LV rotational mechanics.
Authors:A Nemes, A Kalapos, P Domsik, M Oszlánczi, C Lengyel, L Balogh and T Forster
Myocardial contractility of the left ventricle (LV) is related to arterial distensibility. Sport activity is frequently associated with changes in both LV and arterial functions. This study aimed to find correlations between three-dimensional speckle-tracking echocardiography-derived segmental LV deformation parameters and echocardiographically assessed aortic stiffness index (ASI) in athletes. This study comprised 26 young elite athletes (mean age: 26.7 ± 8.4 years, nine men).
Among segmental circumferential strains (CSs), only that of apical anterior (r = 0.40, p = 0.05), septal (r = 0.47, p = 0.01), inferior (r = 0.59, p = 0.001), lateral (r = 0.44, p < 0.05), and midventricular anteroseptal (r = 0.44, p < 0.05) segments correlated with ASI, whereas LV-CS of the midventricular anterior segment showed a correlation tendency. Only longitudinal strain of basal anteroseptal (r = −0.46, p < 0.05) and inferoseptal (r = −0.57, p < 0.01) segments showed correlations with ASI, whereas that of the basal anterior segment had only a tendency to correlate. Some segmental multidirectional strains also correlated with ASI.
Correlations could be demonstrated between increased aortic stiffness and circular function of the apical and midventricular LV fibers and longitudinal motion of the basal septum and LV anterior wall (part of LV outflow tract) in maintaining circulation in the elite athletes.
Authors:Attila Nemes, GyÁ Piros, P Domsik, A Kalapos, Cs Lengyel, A Orosz and T Forster
Left atrial (LA) distension has been demonstrated to be linked with aortic stiffness in different patient populations. Three-dimensional (3D) speckle-tracking echocardiography (STE) seems to be a promising tool for volumetric and functional evaluation of the LA. The aim of the present study was to determine whether correlations exist between 3DSTE-derived LA volume-based and strain parameters characterizing all phasic functions of the LA and echocardiographic aortic elastic properties in healthy subjects. The study included 19 healthy volunteers (mean age: 37.9 ± 11.4 years, 11 men) who had undergone complete two-dimensional (2D) Doppler transthoracic echocardiography extended with the assessment of aortic elastic properties and 3DSTE. Results: None of LA volumes correlated with echocardiographic aortic elastic properties. Active atrial stroke volume correlated with aortic stiffness index (ASI, r = 0.45, p = 0.05). None of other volume-based functional properties signifcantly correlated with aortic stiffness parameters. Global peak 3D strain correlated with aortic strain (r = ‒0.46, p = 0.05). global radial pre-atrial contraction strain correlated with ASI (r = ‒0.49, p = 0.04) and AS (r = ‒0.50, p = 0.04). Conclusions: Correlations exist between 3DSTE-derived LA functional parameters and eschocardiographic aortic elastic properties in healthy subjects.
Authors:V Sasi, H Gavallér, A Kalapos, P Domsik, FT Nagy, T Ungi, I Ungi, T Forster and Attila Nemes
Tissue level myocardial perfusion is one of the most important prognostic factors after successful recanalisation of the occluded coronary artery in patients suffering acute ST elevation myocardial infarction (STEMI). The primary objective of the present study was to examine the relationship between videodensitometric myocardial perfusion parameters as assessed on coronary angiograms directly following successful recanalization therapy and magnetic resonance imaging (MRI)-derived myocardial tissue loss late after STEMI. The study comprised 29 STEMI patients. Videodensitometric parameter Gmax/Tmax was calculated to characterize myocardial perfusion, derived from the plateau of grey-level intensity (Gmax), divided by the time-to-peak intensity (Tmax). Myocardial loss index (MLI) was assessed by cardiac MRI following 376 ± 254 days after PCI. Results: Signifcant correlations could be demonstrated between MLI and Gmax (r = 0.36, p = 0.05) and Gmax/Tmax (r = 0.40, p = 0.03) using vessel masking. Using receiver operating characteristic curve analysis, Gmax/Tmax < 2.17 predicted best MLI = 0.3, 0.4, 0.5 and 0.6 with good sensitivity and specifcity data, while Gmax/Tmax < 3.25 proved to have a prognostic role in the prediction of MLI = 0.7. Conclusions: Selective myocardial tissue level perfusion quantitative measurement method is feasible and can serve as a good predictor of myocardial tissue loss following STEMI and revascularization therapy.