Publications (2)1.83 Total impact
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Article: Additive value of torsion to global longitudinal left ventricular strain in patients with reduced ejection fraction.
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ABSTRACT: Torsional and longitudinal deformations are essential components of left ventricular (LV) performance. A precise assessment of LV function must take into account both LV torsion (LVtor) and global longitudinal strain (LVE). We compared a new 2D-strain parameter, LVtor x LVE, with several other echocardiographic parameters, with respect to their strength of association with N-terminal pro-brain natriuretic peptide (NTproBNP) in patients with reduced LV ejection fraction (LVEF). Echocardiography was performed simultaneously with NTproBNP determination in 78 consecutive patients with reduced LVEF (<50%) in sinus rhythm. Early diastolic transmitral velocity/early mitral annular diastolic velocity ratio (E/E') and systolic mitral annular velocity (S') were measured. LVtor was defined as the ratio between LV twist (LVtw) and LV end-diastolic longitudinal length. LVtw (net difference between rotation angles at base and apex) was obtained from parasternal apical and basal short-axis planes. LVE was obtained by averaging longitudinal peak systolic strain of all 17 LV-segments (from apical planes). Log-transformed NTproBNP correlated significantly with LVE (r = 0.57, P < 0.001), myocardial performance index (r = 0.56, P < 0.001), systolic pulmonary artery pressure (r = 0.47, P < 0.001), E/E' (r = 0.41, P < 0.001), LVtor (r = -0.37, P = 0.001), E-velocity deceleration time (r = -0.37, P = 0.003), S' (r = -0.36, P = 0.002), LVtw (r = -0.34, P = 0.003), LVEF (r = -0.34, P = 0.003), E/A (A = late diastolic transmitral velocity, r = 0.30, P = 0.01) and E (r = 0.28, P = 0.03). LVtor x LVepsilon had the strongest correlation with log-NTproBNP (r = 0.70, P < 0.001). LVtor x LVepsilon was a better predictor of NTproBNP > 900 pg/ml (sensitivity = 82%, specificity = 84%) than other investigated parameters (each P < 0.05). In patients with reduced LVEF, LVtor x LVE is a promising parameter that deserves research to establish its clinical meaning and prognostic value.Acta cardiologica 10/2011; 66(5):565-72. · 0.61 Impact Factor -
Article: The value of a new speckle tracking index including left ventricular global longitudinal strain and torsion in patients with dilated cardiomyopathy.
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ABSTRACT: Torsional and longitudinal deformations are essential components of left ventricular (LV) performance. We believe that a precise assessment of LV function must take into account both LV torsion (LVtor) and global longitudinal strain (LVε). Therefore, we investigated with speckle tracking echocardiography the value of a new parameter, LVtor × LVε, for assessing LV function in dilated cardiomyopathy (DCM) and validated it against N-terminal pro-brain natriuretic peptide (NTproBNP). Echocardiography was performed simultaneously with NTproBNP determination in 55 consecutive patients with DCM in sinus rhythm. The ratio of early diastolic transmitral velocity to early mitral annular diastolic velocity (E/E') was measured. LVtor was defined as the ratio between LV twist (LVtw) and LV enddiastolic longitudinal length. LVtw (net difference between rotation angles at base and apex) was obtained from parasternal apical and basal short-axis planes. LVε was obtained by averaging longitudinal peak systolic strain of all 17 LV-segments (from apical planes). Log-transformed NTproBNP correlated significantly with LVε (r=0.56, p<0.001), E/E' (r=0.52, p<0.001), LVtor (r=-0.41, p=0.003), LVtw (r=-0.38, p=0.004) and LV ejection fraction (r=-0.37, p=0.005). LVtor × LVε had the strongest correlation with log-NTproBNP (r=0.71, p<0.001). LVtor × LVε was a better predictor of NTproBNP levels >900 pg/ml (sensitivity 73%, specificity 82%) than LVε, E/E', LVtw, LVtor and LV ejection fraction (each p<0.05). This study demonstrates that in patients with DCM in sinus rhythm, the evaluation of LV function can be accurately accomplished by using a new speckle tracking index, LVtor × LVε.Hellenic journal of cardiology: HJC = Hellēnikē kardiologikē epitheōrēsē 52(4):299-306. · 1.23 Impact Factor
