Semi-automated volume-strain loops: A new tool in TTE to assess diastolic dysfunction - 06/01/20
Résumé |
Aim |
This work aims to evaluate a novel semi-automatic tool for the assessment of volume-strain loops by transthoracic echocardiography (TTE). The proposed method was evaluated on a typical model of left ventricular (LV) diastolic dysfunction: the cardiac amyloidosis.
Method |
Seventeen patients with proved cardiac amyloidosis and 18patients with heart failure with preserved ejection fraction (HFpEF) were compared to 19controls, from a local database. All TTE were performed using Vivid E9 or E95 ultrasound system (General Electrics Healthcare, Horten, Norway). The complete method includes several steps: 1) extraction of LV strain full traces from apical 4 and 2 cavities views, 2) estimation of LV volume from these two traces by spline interpolations, 3) resampling of LV strain curves, determined for the same cardiac beat, (in apical 4-, 2- and 3- cavities views) as a function of pre-defined percentage increments of LV-volume and 4) calculation of the LV volume-strain loop area. (Fig. 1, panel A)
Results |
(Table 1): LVEF was similar between all groups whereas global longitudinal strain was significantly lower in amyloidosis group than controls (−14.4 vs. −20.5%; P<0.001). HFpEF and amyloidosis groups had a worse diastolic function than controls with a greater left atrial volume index (51 vs. 22mL/m2), a faster tricuspid regurgitation (3.1 and 2.7 vs. 2.0m/s), a greater E/e’ ratio (13.7 and 17.3 vs. 5.9) with a P<0.001 for all these indices. Simultaneously, the global area of volume-strain loop was significantly lower in HFpEF and amyloidosis group than controls (72 vs. 36 vs. 120.0%mL, respectively, P<0.0001). HFpEF has an intermediate profile between controls and amyloidosis (Fig. 1, panel B, HFpEF in green). This area was better correlated with mean e’ (r=0.650, P<0.001) than all other indices.
Conclusion |
LV volume-strain loop area appears a very promising new tool to assess semi-automatically diastolic function.
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Vol 12 - N° 1
P. 56 - janvier 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.