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Objective: To evaluate the utility of two-dimensional multiplanar speckle tracking strain to assess for cardiotoxicity post allogenic bone marrow transplantation (BMT) for haematological conditions.Methods: Cross-sectional study of 120 consecutive patients post-BMT (80 pretreated with anthracyclines (BMT+AC), 40 BMT alone) recruited from a late effects haematology clinic, compared with 80 healthy controls, as part of a long-term cardiotoxicity surveillance study (mean duration from BMT to transthoracic echocardiogram 6±6 years). Left ventricular global longitudinal strain (LV GLS), global circumferential strain (LV GCS) and right ventricular free wall strain (RV FWS) were compared with traditionl parameters of function including LV ejection fraction (LVEF) and RV fractional area change.Results: LV GLS (-17.7±3.0% vs -20.2±1.9%), LV GCS (-14.7±3.5% vs -20.4±2.1%) and RV FWS (-22.6±4.7% vs -28.0±3.8%) were all significantly (p=0.001) reduced in BMT+AC versus controls, while only LV GCS (-15.9±3.5% vs -20.4±2.1%) and RV FWS (-23.9±3.5% vs -28.0±3.8%) were significantly (p=0.001) reduced in BMT group versus controls. Even in patients with LVEF >53%, ~75% of patients in both BMT groups demonstrated a reduction in GCS.Conclusion: Multiplanar strain identifies a greater number of BMT patients with subclinical LV dysfunction rather than by GLS alone, and should be evaluated as part of post-BMT patient surveillence. Reduction in GCS is possibly due to effects of preconditioning, and is not fully explained by AC exposure. [ABSTRACT FROM AUTHOR]

The article focuses on linear correlations between global strain parameters and ejection fraction. It states that ejection fraction represents a relative change in left ventricular volumes, whereas deformation parameters represent relative changes in area. it mentions that left ventricular ejection fraction (LVEF) and myocardial systolic strain search different types of ventricular function and use of other imaging technique to assess LVEF does not help patients with myocardial dysfunction.

Aims: Diastolic dysfunction is frequent in patients with type 2 diabetes mellitus (DM2) and associated with a poor prognosis. This study aimed to describe diastolic function changes over time in DM2 patients and to identify predictive factors of diastolic function deterioration., Methods and Results: Diastolic function was assessed by echocardiography according to the EACVI/ASE recommendations at baseline and 3-year follow-up in a prospective cohort of 310 DM2 patients without overt heart disease. Predictors of diastolic function deterioration were identified using logistic regression analysis. During the 3-year follow-up, prevalence of diastolic dysfunction increased from 49% to 67% (P = 0.001). Only 32% of the patients had a normal diastolic function both at baseline and 3 years and 27% of the patients presented diastolic function deterioration. At multivariable analysis, age (OR = 1.05 [1.01-1.09], P < 0.01), retinopathy (OR = 2.00 [1.10-3.63], P = 0.02), and increase in systolic blood pressure during follow-up (OR = 1.03 [1.01-1.04], P < 0.01) were predictive of diastolic function deterioration., Conclusion: Age, retinopathy, and increase in blood pressure over time are associated with an increased risk of diastolic function deterioration in DM2 patients. The presence of these co-factors might help to early identify patients at risk of heart failure., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.)

Aims: Deformation imaging is undergoing continuous development with the emergence of new technologies allowing the evaluation of the different components of strain simultaneously in three dimensions. Assessment of all global strain parameters in 2D and 3D modes and comparison with LVEF have been the focus of our study., Methods and Results: Out of 166 patients, 147 were evaluated with the use of both 2D and 3D speckle-tracking echocardiography (STE). Global strain parameters including longitudinal (GLS), circumferential (GCS), radial (GRS) and area strain (AS), as well as left ventricular volumes and ejection fraction were examined. Analysis of strain with 3D STE was faster than with 2D STE (7 ± 2 vs. 24 ± 4 min, P < 0.05). GLS values were similar between 2D and 3D modes (-14 ± 4 vs. -13 ± 3, NS), while slight differences were observed for GCS (-24 ± 7 vs. -27 ± 7, P < 0.05) and GRS (27 ± 9 vs. 24 ± 9, P < 0.05). All 2D and 3D strain parameters showed good accuracy in the identification of 2D-LVEF <55% with AS demonstrating superiority over GCS and GRS but not GLS., Conclusion: Three-dimensional STE allows accurate and faster analysis of deformation when compared with 2D STE and might represent a viable alternative in the evaluation of global LV function.

Aims: The aims of this study were (1) to evaluate the relationship between novel two-dimensional transthoracic indices of left atrial (LA) mechanical function (speckle-tracking- and tissue Doppler-derived parameters), conventional indices (A-wave peak velocity and velocity-time integral, and A' velocity), and transoesophageal echocardiographic parameters (LA appendage emptying velocity and spontaneous echocardiographic contrast); and (2) to assess to clinical feasibility of these novel transthoracic echocardiographic indices., Methods and Results: Transthoracic echocardiography was performed immediately prior to or following clinically indicated transoesophageal echocardiography in 100 individuals. Longitudinal reservoir LA strain, and reservoir, conduit, and atrial contractile strain rate were measured by both speckle-tracking and tissue Doppler approaches. Inter- and intra-observer variability in 20 randomly selected cases was evaluated by the Bland-Altman technique. The time required per analysis for these novel transthoracic echocardiographic indices was recorded. In relation to LA appendage emptying velocity, the respective absolute r-values for speckle-tracking reservoir strain, and reservoir, conduit, and atrial contractile strain rate were 0.53 (P < 0.001), 0.40 (P < 0.001), 0.21 (P = 0.05), and 0.61 (P < 0.001). The absolute r-values for tissue Doppler reservoir strain, and reservoir, conduit, and atrial contractile strain rate were 0.57 (P < 0.005), 0.53 (P < 0.001), 0.022 (P = 0.8), and 0.46 (P < 0.001), respectively. In contrast, the r-values for A-wave peak velocity and velocity-time integral, and A' velocity were 0.20 (P = 0.01), 0.26 (P = 0.05), and 0.35 (P = 0.007), respectively. Speckle-tracking-derived parameters achieved the greatest area-under-the-receiver-operating characteristic curve in the identification of moderate-severe LA spontaneous echocardigraphic contrast and were more rapidly measured (P < 0.001), while exhibiting similar reproducibility to tissue Doppler-derived measures., Conclusion: Assessment of LA mechanical function using speckle-tracking echocardiography is a valid approach compared with transoesophageal echocardiography, and is clinically feasible.