ABSTRACT
Introduction: Atrial fibrillation [AF] is a common dysrhythmia postoperatively after coronary artery bypass grafting [CABG]. Myocardial strain and strain-rate imaging is used for the assessment of postoperative atrial fibrillation [POAF] as a new echocardiographic method
Methods: PubMed and Scopus were searched thoroughly using the following search terms: [strain and strain rate] AND [atrial fibrillation OR AF] on March 2015 to find English articles in which the strain and strain-rate echocardiographic imaging had been used for the evaluation of AF in patients undergone CABG. Full text of the relevant papers was fully reviewed for data extraction
Result: Of overall 6 articles found in PubMed, 10 records found in Scopus and 4 articles found through reference list search, only 6 papers fully met the inclusion criteria for further assessment and data extraction. The results of strain and strain-rate assessment showed that in total of 542 patients undergoing CABG, POAF occurred in 106 patients. Studies showed that the reduction of left atrial [LA] strain rate is correlated with AF. Consistently, the results of present review showed that LA strain and strain-rate in patients who developed AF postoperatively after CABG are significantly reduced, suggesting that strain and strain-rate could be a predictor of POAF
Conclusion: Based on the obtained results, strain and strain-rate is a suitable and accurate echocardiographic technique in the assessment of left atrial function, and it might be helpful to detect the patients who are at high risk of POAF
ABSTRACT
Introduction: Left ventricular remodeling is a relatively prevalent complication of acute myocardial infarction [AMI], and it is associated with higher rates of medical issues and mortality. Left ventricle ejection fraction [LVEF] and wall motion score index [WMSI] are unable to detect accurately minor lesions following AMI. Global longitudinal strain [GLS], which is obtained through 2D-speckle tracking echocardiography [2D-STE], provides an angle-dependent measurement by which the infarcted area can be assessed as a means of identifying potential dysfunction. The main objective of this study was to evaluate whether GLS could adequately predict LV remodeling in AMI patients
Methods: The MEDLINE database from database inception to May 6th, 2015, was searched for relevant keywords and the reference lists of systematic reviews and eligible studies were also screened. All studies involving patients with their first reported case of AMI were examined for GLS by 2D-STE and were evaluated for LV remodeling at a three-month follow-up point. Four English-language prospective cohort studies were eligible for inclusion in this study
Result: A total of 291 AMI patients [mean age=57.92 years] were investigated across four different studies. The main finding of this study was that the most reliable and consistent measurement for the purposes of predicting LV remodeling in AMI patients is GLS obtained at the time of discharge, especially in STEMI patients
Discussion: In addition to their poor reproducibility, inability to stratify risks, and inter-observer variability, compensatory hyperkinesis of intact myocytes and myocardial stunning after an AMI are among the main reasons why LVEF and WMSI may not be the most effective predictors of LV remodeling in AMI
Conclusion: GLS obtained by 2D-STE at the time of discharge could be used as a reliable predictor of LV remodeling in AMI patients
ABSTRACT
Introduction: Ischemic heart disease is caused mainly by obstruction of coronary arteries. The ischemic assessment through echocardiography is dependent on wall motion abnormality detection during systole. In patients with ischemic heart disease the diastolic function is impaired before systolic function and measurement of regional diastolic dysfunction if possible will be most sensitive for assessment of obstructed coronary artery region. This study was designed to determine whether regional left ventricular delayed relaxation diagnosis could be detected with strain imaging derived from two-dimensional speckle-tracking echocardiography in patients with coronary artery disease
Methods: All the articles reviewed were obtained using MEDLINE and ScienceDirect [up to October 2014]. All data extracted by speckle tracking echocardiography. The index which is used is strain imaging diastolic index which is calculated as: [A-B] A×100 . A is the amount of strain at the time Aortic value closure and B is the amount of strain in first one-third point of diastolic duration
Results: Four articles were reviewed. Three articles assessed patients with echocardiography at rest and one with stress echocardiography. All articles showed the coronary artery tracking with significant stenosis is possible by regional deformation analysis through two-dimensional strain
Discussion: The usage of strain images obtained through two-dimensional speckle tracking has been validated for the quantitation assessment of regional dysfunction in ischemic heart disease. Regional LV delayed relaxation diagnosis with strain imaging is a reliable method after treadmill stress test
Conclusion: Strain imaging is reasonable for evaluation of ischemia as a low cost noninvasive test with high accuracy
ABSTRACT
Coronary artery diseases affect both systolic and diastolic functions and can be assessed both globally and regionally. Tissue doppler imaging is a novel technique with additional advantages to the currently used twodimensional echocardiography. This paper is a review of the published articles on documented Coronary artery diseases patients confirmed by angiography, without any previous myocardial infarction and with normal left ventricular ejection fraction. Accordingly, a significant relationship was achieved between systolic rather than diastolic parameters with Coronary artery diseases. Furthermore, major heterogeneity was noticed among the available studies in this respect. The incremental values of tissue doppler imaging in patients with stable angina in addition to other non invasive tests has led to its recommendation by ACC/AHA
ABSTRACT
Coronary artery disease is the first etiology of mortality in Western countries and it was predicted, that up to the year 2010 it would be the main cause of human morbidity. With respect to the increasing frequency of coronary artery disease, proper diagnosis, treatment and prevention of complications have a great importance. Many patients with chest pain could not perform diagnostic ETT, so in this group dobutamin stress echocardiography was a suitable low cost, safe, accessible and exercise independent modality of stress. Regarding the recent usage of dobutamine stress echocardiography in our country and especially in khorasan province, the aim of this descriptive study was to present 500 patients whom referred to Ghaem hospital echocardiography laboratory for ischemic diagnosis or viability assessment or both. This study consisted of 500 patients, 273 males [54.6%], and 227 Females [45.4%], 20-80 years old and also were symptomatic for ischemia. These cases were referred to Ghaem echo lab for ischemia/ viability detection between 1385-1386. Our study Patients had: systemic hypertension [46.8%], hypercholesterolemia [39.8%], diabetes [29.5%], smoking [12.6%], previous MI [11.1%] positive family history 8% CRF [8%] and obesity [5%]. Among patients 345 [69%] were referred for ischemia detection, 132 [26.4%] referred for viability assessment, 23 [4.6%] for both of them, the left ventricular systolic function was normal in 168 [26.8%], mildly abnormal in 25.3%, moderate dysfunction in consideration, 402 patients [80.5%] had no complication and in the other patients [19.5%] test complication were occurred as arrhythmia, PVC, palpitation, vomiting, nausea, rigor and the other mild complications. Dobutamine stress echocardiography is an exercise independent stress modality with good safety and low level of complications
Subject(s)
Humans , Female , Male , Coronary Artery Disease , Chest PainABSTRACT
RV function using myocardial velocities before and after a CABG is unknown. CABG on the beating heart without cardiac- pulmonary bypass [off- pump] has gainad increasing popularity. Improved post operative ventricular function has been cited as an advantage over on- pump surgery. A total of 36 pts [26 male and 10 female] with significant coronary artery disease underwent elective CABG, between March 2005 and June 2006. All had pulsed wave TDI and mmode imaging obtained from the apex, visualising the tricuspid free wall annulus. Amplitude of TV annulus displacement and RV systolic and diastolic velocities were compared before and 5 days after surgery. Regional mitral annular velocities were also studied for comparison. Altogether 21 pts Underwent off- pump CABG. Each subject had a mean 2.6 grafts. All left ventricular regional velocities showed a non significant reduction after surgery. TAM and both systolic [S] and diastolic [E and L] velocities in the RV decreased considerably 5 days after CABG. S 12.6 vs 7.7, E 10.8 vs. 7, A 6.6 vs 9, [p-0.000]. The off- pump group had a similar trend with no evidence of preserved RV function compared to the on- pump group. Systolic and diastolic RV function, as assessed by DTI and TAM decreased significantly after CABG. TDI can provide a simple and noninvasive qualitative method for assessing and monitoring of RV function after surgery. Off- pump CABG cannot prevent this malfunction
Subject(s)
Humans , Male , Female , Coronary Artery Bypass , Echocardiography, Doppler, Pulsed , Tricuspid ValveABSTRACT
To evaluate the spectrum of probable vascular complications due to short-term oral contraceptives [OC] consumption. In this cohort study, selected Iranian female pilgrims from Razavi-Khorasan, Iran province <50 years old, attending Hajj in 2005 were evaluated. We reviewed their physical examinations, vascular risk factors and OC consumption before Hajj. Pilgrims were followed-up in terms of developing possible vascular complications during Hajj and the following year. This study included 896 individuals and completed follow-up was performed for 642. The results showed that 782 [87.3%] of pilgrims used OC. One person developed cerebral vein thrombosis, one myocardial infarction, and one deep vein thrombosis. Eighteen patients [2.8%] experienced transient hypertension. Ten patients [1.5%] had migraine exacerbations. The relationship between developed definite vascular complications and OC consumption was not statistically significant in this study p=0.365. Although vascular complications of long-term OC consumption have been analyzed and proved in several studies, few studies have determined short-term OC consumption effects on the vascular system. It seems that even short-term usage of OC may result in vascular complications, thus further studies with more samples is recommended to determine its safety and complications