Impact of surgical aortic valve replacement on global and regional longitudinal strain across four flow gradient patterns of severe aortic stenosis

The International Journal of Cardiovascular Imaging - To evaluate the impact of surgical aortic valve replacement (SAVR) on global (GLS) and regional longitudinal strain (RLS) across four...     

Pulsed-Wave Tissue Doppler and Color Tissue Doppler Echocardiography: Calibration with M-Mode, Agreement, and Reproducibility in a Clinical Setting

Background: Myocardial velocities can be measured with both pulsed-wave tissue Doppler (PWTD) and color tissue Doppler (CTD) echocardiography. We aimed to (A) to explore which of the two methods better approximates true tissue motion and (B) to examine the agreement and the reproducibility of the two methods in a routine clinical setting. Methods: For Study A, the displacements of 63 basal myocardial segments from 13 patients were examined with M-mode and compared with the velocity-time integral of PWTD and CTD velocities. For Study B, the basal lateral segments from 58 patients were examined with PWTD and CTD, and the peak myocardial velocities during systole (Sm), early diastole (Em), and late diastole (Am) were measured. Results: Study A: CTD-based measurements of displacement were 12% lower than M-mode measurements (95% CI: −18%; −6%). PWTD velocity-time integrals measured at the outer edge of the spectral band were 40% higher (33%; 46%) than M-mode measurements. Study B: PWTD measurements of myocardial velocity were systematically higher than CTD measurements: Sm 7.51 versus 5.54, difference 1.97 ± 1.41 cm/sec; Em 8.74 versus 6.86, difference 1.88 ± 1.70 cm/sec; Am 7.46 versus 5.17, difference 2.29 ± 1.82 cm/sec; P < 0.001 for all. Intraobserver coefficient of variation for Sm, Em, and Am were 6%, 12%, and 12% for PWTD, 14%, 13%, and 20% for CTD. Conclusions: CTD measures numerically smaller tissue velocities than PWTD, mostly due to an overestimation of true tissue motion by PWTD. The methods have good agreement and comparable reproducibility.     

A simple linear model for the effect of changes in metabolic risk factors on coronary heart disease

OBJECTIVES: The risk of having one or more metabolic risk factors in the development of coronary heart disease (CHD) is well estimated, but it still remains to be shown which influence any given change in the number of risk factors has on the overall risk of CHD. DESIGN: In this prospective cardiovascular population study, 10 194 participants were examined twice with a 5-year interval for metabolic risk factors such as obesity, hypertension, hypercholesterolaemia and diabetes mellitus. RESULTS: During 14 years of follow-up, 1724 incident cases of CHD were identified, 973 in men and 751 in women. The effect of an increase in the number of metabolic risk factors during a 5-year interval on the relative risk of CHD could be determined to be statistically significant for both genders. But only for men, the effect of a decrease in the number of metabolic risk factors was statistically significant during the same time interval. Hence, by statistical analysis, a simple linear model could be constructed for men with two linear trend parameters, one corresponding to the number of metabolic risk factors at the first examination and one corresponding to the change in the number of metabolic risk factors from the first to the second examination. The parameters were 1.50 (1.39-1.63); P < 0.001 and 1.29 (1.18-1.41); P < 0.001, respectively. CONCLUSIONS: This study suggests that it is possible to fit a simple linear model for the effect of changed number of metabolic risk factors on the risk of CHD.     

The prognostic value of left atrial dyssynchrony measured by speckle tracking echocardiography in the general population

The International Journal of Cardiovascular Imaging - LA dyssynchrony is a predictor of cardiovascular morbidity in various patient populations. However, the prognostic value of LA dyssynchrony as...