Longitudinal strain by speckle tracking echocardiography in constrictive pericarditis

Longitudinal strain by speckle tracking echocardiography in constrictive pericarditis 638 T. Sugimoto et al. European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging with real-time three-dimensional echocardiography. Eur J Echocardiogr 2009;10: 2015;16:233–70. . 738–44. 22. Kurt M, Wang J, Torre-Amione G, Nagueh SF. Left atrial function in diastolic 25. Singh A, Addetia K, Maffessanti F, Mor-Avi V, Lang RM. LA strain for heart failure. Circ Cardiovasc Imaging 2009;2:10–5. categorization of LV diastolic dysfunction. JACC Cardiovasc Imaging 2017;10: 23. Wu VC, Takeuchi M, Kuwaki H, Iwataki M, Nagata Y, Otani K et al. Prognostic 735–43. value of LA volumes assessed by transthoracic 3D echocardiography: compari- . 26. Khurram IM, Maqbool F, Berger RD, Marine JE, Spragg DD, Ashikaga H et al. son with 2D echocardiography. JACC Cardiovasc Imaging 2013;6:1025–35. Association between left atrial stiffness index and atrial fibrillation recurrence in 24. Aune E, Baekkevar M, Roislien J, Rodevand O, Otterstad JE. Normal reference patients undergoing left atrial ablation. Circ Arrhythm Electrophysiol 2016;9: ranges for left and right atrial volume indexes and ejection fractions obtained e003163. IMAGE FOCUS doi:10.1093/ehjci/jey031 Online publish-ahead-of-print 23 February 2018 .................................................................................................................................................... Longitudinal strain by speckle tracking echocardiography in constrictive pericarditis 1 2 2 1 1 Edith Jottrand , Thomas Serste , Jean-Pierre Mulkay , Charlotte Vandueren , and Philippe Unger * 1 2 Department of Cardiology, CHU Saint-Pierre, Universite´ Libre de Bruxelles (ULB), 322 rue Haute, Brussels B-1000, Belgium; and Department of Gastroenterology, CHU Saint-Pierre, Universite´ Libre de Bruxelles (ULB), 322 rue Haute, Brussels B-1000, Belgium * Corresponding author. Tel: 132 2 535 33 51, Fax: 132 2 535 33 62. E-mail: punger@ulb.ac.be A 58-year-old patient presenting cholestasis was referred for cardiac evaluation follow- ing the detection of a 25 mmHg right atrial pressure during hepatic catheterization. Echocardiography demonstrated a 65% left ventricular ejection fraction and a normal sized right ventricle, without tricuspid regur- gitation. There was respiratory interventricu- lar septal shift (Supplementary data online, Video S1), without pericardial effusion. Pulsed wave Doppler demonstrated a 36% expira- tory increase in transmitral peak E wave vel- ocity (Panel A), a dilated inferior vena cava (Panel B), and hepatic vein expiratory dia- stolic flow reversal (*, Panel C). Tissue Doppler imaging demonstrated higher medial than lateral early diastolic annulus velocities (23 cm/s and 15 cm/s, respectively) (Panels D, E). By speckle tracking imaging, global longitu- dinal strain was 17.6%; anterior, lateral, and inferolateral segments had on the average lowervalues(14.0%) than septal segments (22.6%), as depicted by the bull’s eye rep- resentation (Panel F). These findings were deemed consistent with the diagnosis of con- strictive pericarditis. Thickened pericardium (5 mm) was demonstrated by computed tomography (Panel G). Unlike restrictive cardiomyopathies—where longitudinal strain is usually uniformly reduced, the typical longitudinal deformation pattern of constrictive pericarditis includes preserved septal and reduced longitudinal strain values in left ventricular free wall myocardial segments due to pericardial adhesions. This specific pattern can be easily appreciated by a bull’s eyes map which may provide incremental information to ascertain the diagnosis of pericardial constriction. Supplementary data are available at European Heart Journal - Cardiovascular Imaging online. V C Published on behalf of the European Society of Cardiology. All rights reserved. The Author(s) 2018. For permissions, please email: journals.permissions@oup.com. Downloaded from https://academic.oup.com/ehjcimaging/article-abstract/19/6/638/4907937 by Ed 'DeepDyve' Gillespie user on 20 June 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Heart Journal – Cardiovascular Imaging Oxford University Press

Longitudinal strain by speckle tracking echocardiography in constrictive pericarditis

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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.
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Abstract

638 T. Sugimoto et al. European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging with real-time three-dimensional echocardiography. Eur J Echocardiogr 2009;10: 2015;16:233–70. . 738–44. 22. Kurt M, Wang J, Torre-Amione G, Nagueh SF. Left atrial function in diastolic 25. Singh A, Addetia K, Maffessanti F, Mor-Avi V, Lang RM. LA strain for heart failure. Circ Cardiovasc Imaging 2009;2:10–5. categorization of LV diastolic dysfunction. JACC Cardiovasc Imaging 2017;10: 23. Wu VC, Takeuchi M, Kuwaki H, Iwataki M, Nagata Y, Otani K et al. Prognostic 735–43. value of LA volumes assessed by transthoracic 3D echocardiography: compari- . 26. Khurram IM, Maqbool F, Berger RD, Marine JE, Spragg DD, Ashikaga H et al. son with 2D echocardiography. JACC Cardiovasc Imaging 2013;6:1025–35. Association between left atrial stiffness index and atrial fibrillation recurrence in 24. Aune E, Baekkevar M, Roislien J, Rodevand O, Otterstad JE. Normal reference patients undergoing left atrial ablation. Circ Arrhythm Electrophysiol 2016;9: ranges for left and right atrial volume indexes and ejection fractions obtained e003163. IMAGE FOCUS doi:10.1093/ehjci/jey031 Online publish-ahead-of-print 23 February 2018 .................................................................................................................................................... Longitudinal strain by speckle tracking echocardiography in constrictive pericarditis 1 2 2 1 1 Edith Jottrand , Thomas Serste , Jean-Pierre Mulkay , Charlotte Vandueren , and Philippe Unger * 1 2 Department of Cardiology, CHU Saint-Pierre, Universite´ Libre de Bruxelles (ULB), 322 rue Haute, Brussels B-1000, Belgium; and Department of Gastroenterology, CHU Saint-Pierre, Universite´ Libre de Bruxelles (ULB), 322 rue Haute, Brussels B-1000, Belgium * Corresponding author. Tel: 132 2 535 33 51, Fax: 132 2 535 33 62. E-mail: punger@ulb.ac.be A 58-year-old patient presenting cholestasis was referred for cardiac evaluation follow- ing the detection of a 25 mmHg right atrial pressure during hepatic catheterization. Echocardiography demonstrated a 65% left ventricular ejection fraction and a normal sized right ventricle, without tricuspid regur- gitation. There was respiratory interventricu- lar septal shift (Supplementary data online, Video S1), without pericardial effusion. Pulsed wave Doppler demonstrated a 36% expira- tory increase in transmitral peak E wave vel- ocity (Panel A), a dilated inferior vena cava (Panel B), and hepatic vein expiratory dia- stolic flow reversal (*, Panel C). Tissue Doppler imaging demonstrated higher medial than lateral early diastolic annulus velocities (23 cm/s and 15 cm/s, respectively) (Panels D, E). By speckle tracking imaging, global longitu- dinal strain was 17.6%; anterior, lateral, and inferolateral segments had on the average lowervalues(14.0%) than septal segments (22.6%), as depicted by the bull’s eye rep- resentation (Panel F). These findings were deemed consistent with the diagnosis of con- strictive pericarditis. Thickened pericardium (5 mm) was demonstrated by computed tomography (Panel G). Unlike restrictive cardiomyopathies—where longitudinal strain is usually uniformly reduced, the typical longitudinal deformation pattern of constrictive pericarditis includes preserved septal and reduced longitudinal strain values in left ventricular free wall myocardial segments due to pericardial adhesions. This specific pattern can be easily appreciated by a bull’s eyes map which may provide incremental information to ascertain the diagnosis of pericardial constriction. Supplementary data are available at European Heart Journal - Cardiovascular Imaging online. V C Published on behalf of the European Society of Cardiology. All rights reserved. The Author(s) 2018. For permissions, please email: journals.permissions@oup.com. Downloaded from https://academic.oup.com/ehjcimaging/article-abstract/19/6/638/4907937 by Ed 'DeepDyve' Gillespie user on 20 June 2018

Journal

European Heart Journal – Cardiovascular ImagingOxford University Press

Published: Feb 23, 2018

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