The International Journal of Cardiovascular Imaging

Reiber, Johan H. C.

doi: 10.1007/s10554-022-02713-wpmid: N/A

Bai, Xue; Liu, Wenjun; Huang, Hui; You, Huan

doi: 10.1007/s10554-022-02574-3pmid: 35220527

Pulse wave velocity (PWV) can evaluate potential atherosclerosis (AS) and ultrafast pulse wave velocity (ufPWV) is a new technique to accurately assess PWV. However, few studies have examined the predictive value of ufPWV for AS risk. We aimed to establish a classification model for AS risk diagnosis based on ufPWV, so that AS can be diagnosed and prevented in advance. We collected imaging data, as well as clinical and laboratory data. A total of 613 patients with 20 attributes were admitted in this study. There were 392 patients with hyperlipidemia (AS risk group) and 221 healthy adults as the control group. In order to build AS risk prediction models, we considered decision tree, five different ensemble learning (EL) models [random forest (RF), adaptive boosting (AdaBoost), gradient boosting decision tree (GBDT), extreme gradient boosting (XGBoost) and light gradient boosting machine (LGBM)] and two different feature selection methods [statistical analysis and RF]. Accuracy and the area under the ROC curve (AUC) were used as the main criterion for model evaluation. In the prediction of AS risk with statistical analysis as the feature selection method, the performances of XGBoost (accuracy: 0.851; AUC: 0.884) and RF (accuracy: 0.844; AUC: 0.889) were better than other models. Besides, in the prediction of AS risk with RF as the feature selection method, the performances of LGBM (accuracy: 0.870; AUC: 0.903) and XGBoost (accuracy: 0.857; AUC: 0.903) were better than other models. In conclusions, EL models with RF as the feature selection method might provide accurate results in predicting AS risk. Besides, ufPWV, especially PWV of left common carotid artery at the end of systole, was an important feature in the AS risk prediction models.

Sonaglioni, Andrea; Nicolosi, Gian Luigi; Bianchi, Stefano; Lombardo, Michele

doi: 10.1007/s10554-022-02579-ypmid: N/A

PurposeNo previous study provided a complete functional evaluation of all cardiac chambers in pregnant women with obesity. Moreover, the impact of cardiovascular changes associated with obesity in pregnancy on maternal outcome is unclear.Methods46 consecutive pregnant women with obesity, defined by body mass index (BMI) ≥ 30 Kg/m2, and 83 age- (35.5 ± 4.1 vs. 34.1 ± 5.1 yrs, p = 0.11), ethnicity- (caucasian 65.2 vs. 66.3%, p = 0.90) and gestational week-matched (36.3 ± 1.7 vs. 36.5 ± 1.5 wks, p = 0.49) pregnant women without obesity (BMI < 30 Kg/m2) were examined in the first trimester (12–14 weeks), third trimester (36–38 weeks) and 6–10 weeks postpartum. All women underwent obstetric visit, blood tests and transthoracic echocardiography implemented with two-dimensional speckle tracking echocardiography analysis of biventricular and biatrial myocardial deformation indices at the three time points. Outcome was persistent subclinical myocardial dysfunction, defined as an absolute value of left ventricular global longitudinal strain (LV-GLS) less negative than − 20%, in postpartum.ResultsDespite normal biventricular systolic function, all myocardial strain indices were significantly lower in pregnant women with obesity than controls. At 8.2 ± 2.2 weeks postpartum, LV-GLS remained less negative than − 20% in 86.9% of women with obesity in pregnancy. Maternal age (OR 1.68, 95%CI 1.14–2.48), third trimester BMI (OR 7.17, 95%CI 1.77–28.9) and third trimester neutrophil-to-lymphocyte ratio (NLR) (OR 1.75, 95%CI 1.22–2.51) were independently associated with outcome. Maternal age ≥ 35 years, BMI ≥ 30 Kg/m2 and NLR ≥ 5.5 were the optimal cut-off values for predicting persistent subclinical myocardial dysfunction in postpartum.ConclusionsPregnant women with obesity, age ≥ 35 yrs and low chronic inflammation have significantly increased risk of persistent subclinical myocardial dysfunction over postpartum.

Kim, Hyungseop; Kim, In-Cheol; Hwang, Jongmin; Park, Hyoung-Seob; Lee, Cheol Hyun; Cho, Yun-Kyeong; Yoon, Hyuck-Jun; Nam, Chang-Wook; Han, Seongwook; Hur, Seung-Ho

doi: 10.1007/s10554-022-02583-2pmid:

Duus, Lisa Steen; Olsen, Flemming Javier; Lindberg, Søren; Fritz-Hansen, Thomas; Pedersen, Sune; Iversen, Allan; Galatius, Søren; Møgelvang, Rasmus; Biering-Sørensen, Tor

doi: 10.1007/s10554-022-02584-1pmid: N/A

Liu, Mengmeng; Sun, Mengjiao; Li, Lijin; Li, Pengge; Hou, Suyun; Li, Zhen; Sun, Xinxin; Hua, Shaohua

doi: 10.1007/s10554-022-02585-0pmid: 35254610

Athletes might suffer from potentially fatal heart disease, which has always been a concern in cardiovascular medicine. The changes in left atrial (LA) size and function are related to the occurrence of arrhythmia. In the present study, four-dimensional automatic quantitation (4D LAQ) was used to explore the changes in LA function of young strength athletes. Eighty professional young strength athletes and sixty healthy young adults matched in age were selected for the study. The LA volumes and strains were automatically analyzed by 4D LAQ. The receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of strain in athletes' LA function. Pearson correlation analysis was performed to assess the potential association between conventional echocardiographic indexes and 4D parameters related to athletes' LA function. Compared to the control group, LA longitudinal and circumferential strain in the athlete group decreased, while LA volume increased (P < 0.05). However, LA strain was similar among 45 male and 35 female strength athletes (P > 0.05), while male athletes presented with a higher LA volume when compared to female controls (P < 0.05). ROC curve analysis showed that LA contraction longitudinal strain (LASct) was the best predictor in evaluating athletes' LA function. Athletes' heart rate and left ventricular mass index were significantly correlated with 4D LA function parameters.4D LAQ can be used for early detection of the changes in LA function in young strength athletes. There was no significant difference in LA strain between male and female athletes. The LASct was the most effective index for evaluating athletes' LA function.

Rhee, Tae-Min; Kim, Hyung-Kwan; Choi, You-Jung; Lee, Hyun-Jung; Hwang, In-Chang; Yoon, Yeonyee E.; Kim, Hack-Lyoung; Park, Jun-Bean; Lee, Seung-Pyo; Kim, Yong-Jin; Cho, Goo-Yeong

doi: 10.1007/s10554-022-02589-w

Elffers, T. W.; de Graaf, M. A.; Regeer, M. V.; Omara, S.; Schalij, M. J.; Groeneveld, G. H.; Roukens, A. H. E.; Geelhoed, J. J. M.; Antoni, M. L.

doi: 10.1007/s10554-022-02590-3pmid: N/A

In hospitalized COVID-19 patients, myocardial injury and echocardiographic abnormalities have been described. The present study investigates cardiac function in COVID-19 patients 6 weeks post-discharge and evaluates its relation to New York Heart Association (NYHA) class. Furthermore cardiac function post-discharge between the first and second wave COVID-19 patients was compared. We evaluated 146 patients at the outpatient clinic of the Leiden University Medical Centre. NYHA class of II or higher was reported by 53% of patients. Transthoracic echocardiography was used to assess cardiac function. Overall, in 27% of patients reduced left ventricular (LV) ejection fraction was observed and in 29% of patients LV global longitudinal strain was impaired (> − 16%). However no differences were observed in these parameters reflecting LV function between the first and second wave patients. Right ventricular (RV) dysfunction as assessed by tricuspid annular systolic planar excursion (< 17 mm) was present in 14% of patients, this was also not different between the first and second wave patients (15% vs. 12%; p = 0.63); similar results were found for RV fraction area change and RV strain. Reduced LV and RV function were not associated with NYHA class. In COVID-19 patients at 6 weeks post-discharge, mild abnormalities in cardiac function were found. However these were not related to NYHA class and there was no difference in cardiac function between the first and second wave patients. Long term symptoms post-COVID might therefore not be explained by mildly abnormal cardiac function.

Ekhomu, Omonigho; Faerber, Jennifer A.; Wang, Yan; Huang, Jing; Mai, Anh Duc; DiLorenzo, Michael P.; Bhatt, Shivani M.; Avitabile, Catherine M.; Mercer-Rosa, Laura

doi: 10.1007/s10554-022-02595-ypmid: N/A

Diastolic dysfunction after repair for Tetralogy of Fallot (TOF) is associated with adverse long-term outcomes. Right atrial (RA) mechanics as a proxy of right ventricular (RV) diastolic function in the early post-operative period after surgical repair for TOF has not been reported. We sought to evaluate RA and RV strain prior to hospital discharge after TOF repair and to identify important patient factors associated with strain using a machine learning method. Single center retrospective cohort study of TOF patients undergoing surgical repair, with analysis of RA and RV strain from pre-and post-operative echocardiograms. RA function was assessed by the peak RA strain, systolic RA strain rate, early diastolic RA strain rate and RA emptying fraction. RV systolic function was measured by global longitudinal strain. Pre- and post-operative values were compared using Wilcoxon rank sum test. Gradient boosted machine (GBM) models were used to identify the most important predictors of post-operative strain. In total, 153 patients were enrolled, median age at TOF repair 3.5 months (25th-75th percentile: 2.2- 5.2), mostly male (67%), and White (64.1%). From pre-to post-operative period, there was significant worsening in all RA parameters and in RV strain. GBM models identified patient, anatomic, and surgical factors that were strong predictors of post-operative RA and RV strain. These factors included pulmonary valve and branch pulmonary artery Z scores, birth weight, gestational age and age at surgery, pre-operative RV fractional area change and oxygen saturation, type of outflow tract repair, duration of cardiopulmonary bypass, and early post-operative partial arterial pressure of oxygen. There is significant worsening in RA and RV strain early after TOF repair, indicating early alteration in diastolic and systolic function after surgery. Several patient and operative factors influence post-operative RV function. Most of the factors described are not readily modifiable, however they may inform pre-operative risk-stratification. The clinical application of RA strain and the prognostic implication of these early changes merit further study.

Kuneman, Jurrien H.; Butcher, Steele C.; Stassen, Jan; Singh, Gurpreet K.; Pio, Stephan M.; van der Kley, Frank; Ajmone Marsan, Nina; Knuuti, Juhani; Bax, Jeroen J.; Delgado, Victoria

doi: 10.1007/s10554-022-02596-xpmid: 37726606

Women with severe aortic stenosis (AS) have better long-term prognosis after transcatheter aortic valve implantation (TAVI) compared to men. Whether this is caused by sex-related differences in left ventricular (LV) reverse remodeling after TAVI is unknown. Patients with severe AS who underwent transfemoral TAVI between 2007 and 2018 were selected. LV dimensions, volumes, and ejection fraction (LVEF) were assessed by transthoracic echocardiography before TAVI and at 6 and 12 months follow-up after TAVI. LV reverse remodeling was defined as the percentual LV mass index (LVMi) reduction compared to baseline. The primary outcome was all-cause mortality. A total of 459 patients (80 ± 8 years; 52% male) were included. At 6 and 12 months follow-up, both sexes showed significant reductions in LV volumes and LVMi accompanied by improvement in LVEF, without significant differences between the sexes over time. During a median follow-up of 2.8 [IQR 1.9–4.3] years, 181 (39%) patients died. Women showed better outcomes compared to men (log-rank p = 0.024). In addition, male sex was independently associated with all-cause mortality in multivariable Cox regression (HR 1.423, 95% CI 1.039–1.951, p = 0.028). No association was observed between the interaction of percentual LVMi reduction and sex with outcomes (p = 0.64). Men and women with severe AS had similar improvement in LVEF, and similar reductions in LV volumes and LVMi at 6 and 12 months after TAVI. Women showed better survival after TAVI as compared to men. The superior outcomes noted in women after TAVI are not associated with sex differences in LV reverse remodeling.Graphical abstract[graphic not available: see fulltext]