Speckle-tracking echocardiography capabilities in the diagnosis of subclinical left ventricular dysfunction
AbstractOne of the main strategic directions in the effective treatment of patients with chronic heart failure, improving their quality of their life, reducing mortality and increasing life expectancy is defecting of this pathology at the earliest possible stages. Recent studies have shown that such an exponent as the ejection fraction is only an indicator of global heart function and cannot be used to detect ventricular dysfunction in the early stages of the disease. The development of speckle-tracking echocardiography marked a new era in echocardiographic imaging. Indicators such as global longitudinal deformation and myocardial work more accurately reflect left ventricular dysfunction than the traditional definition of ejection fraction, which can be used to identify asymptomatic left ventricular dysfunction, as well as to predict adverse cardiovascular events.
Keywords:chronic heart failure; subclinical left ventricular dysfunction; echocardiography; speckle-tracking echocardiography; global longitudinal deformation; myocardial work of the left ventricle
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Ponomarenko I.V., Sukmanova I.A., Sanaeva A.K., Trubina E.V., Narenkova S.O. Speckle-tracking echocardiography capabilities in the diagnosis of subclinical left ventricular dysfunction. Kardiologiya: novosti, mneniya, obuchenie [Cardiology: News, Opinions, Training]. 2023; 11 (2): 22–9. DOI: https://doi.org/10.33029/2309-1908-2023-11-2-22-29 (in Russian)
References
1. Tereshchenko S.N., Zhirov I.V. Chronic heart failure: New challenges and new perspectives. Terapevticheskiy arkhiv [Therapeutic Archive]. 2017; 89 (9): 4–9. DOI: https://doi.org/10.17116/terarkh20178994–9 (in Russian)
2. Chu A., Wu T., Zhang L., Zhang Z. The prognostic value of left atrial and left ventricular strain in patients after ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. Cardiol J. 2021; 28 (5): 678–89. DOI: https://doi.org/10.5603/CJ.a2020.0010
3. Nesterov V.S., Urvantseva I.A., Vorob’ev A.S. Chronic heart failure: modern problems and their solutions. Lechashchiy vrach [Attending Physician]. 2018; (7): 11–4. (in Russian)
4. Solomon S.D., Boer R.A., DeMets D., Hernandez A.F., Inzucchi S.E., Kosiborod M.N., et al. Dapagliflozin in heart failure with preserved and mildly reduced ejection fraction: rationale and design of the DELIVER trial. Eur J Heart Fail. 2021; 23 (7): 1217–25. DOI: https://doi.org/10.1002/ejhf.2249 Epub 2021 Jun 9.
5. Scharrenbroich J., Hamada S., Keszei A., Schröder J., Napp A., Almalla M., et al. Use of two-dimensional speckle tracking echocardiography to predict cardiac events: Comparison of patients with acute myocardial infarction and chronic coronary artery disease. Clin Cardiol. 2018; 41: 111–8. DOI: https://doi.org/10.1002/clc.22860
6. Prastaro M., Pirozzi E., Gaibazzi N., Paolillo S., Santoro C., Savarese G., et al. Expert review on the prognostic role of echocardiography after acute myocardial infarction. J Am Soc Echocardiogr. 2017; 30 (5): 431–43.e2. DOI: https://doi.org/10.1016/j.echo.2017.01.020
7. Hsiao J., Chung C., Chu C., Lin Y., Pan K., Chang S., et al. Two-dimensional speckle tracking echocardiography predict left ventricular remodeling after acute myocardial infarction in patients with preserved ejection fraction. PLos One. 2016; 11 (12): e0168109. DOI: https://doi.org/10.1371/journal.pone.0168109 Epub 2016 Dec 29.
8. Hiebert J.B., Vacek J., Shah Z., Rahman F., Pierce J.D. Use of speckle tracking to assess heart failure with preserved ejection fraction. J Cardiol. 2019; 74 (5): 397–402. DOI: https://doi.org/10.1016/j.jjcc.2019.06.004
9. Rimbas R.C., Visoiu I.S., Magda S.L., Mihaila-Baldea S., Luchian M.L., Chitroceanu A.M., et al. New insights into the potential utility of the left atrial function analysis in heart failure with preserved ejection fraction diagnosis. PLoS One. 2022; 17 (5): e0267962. DOI: https://doi.org/10.1371/journal.pone.0267962
10. Pieske B., Tschöpe C., Boer R.A., Fraser A.G., Anker S.A., Donal E., et al. How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Eur Heart J. 2019; 40 (40): 3297–317. DOI: https://doi.org/10.1093/eurheartj/ehz641
11. Butler J., Filippatos G., Siddiqi T.J., Brueckmann M., Böhm M., Chopra V.K., et al. Empagliflozin, health status, and quality of life in patients with heart failure and preserved ejection fraction: the EMPEROR-preserved trial. Circulation. 2022; 145 (3): 184–93. DOI: https://doi.org/10.1161/CIRCULATIONAHA.121.057812 Epub 2021 Nov 15.
12. Luis S.A., Chan J., Pellikka P.A. Echocardiographic assessment of left ventricular systolic function: an overview of contemporary techniques, including speckle-tracking echocardiography. Mayo Clin Proc. 2019; 94 (1): 125–38. DOI: https://doi.org/10.1016/j.mayocp.2018.07.017
13. Cameli M., Mandoli G.E., Sciaccaluga C., Mondillo S. More than 10 years of speckle tracking echocardiography: still a novel technique or a definite tool for clinical practice? Echocardiography. 2019; 36 (5): 958–70. DOI: https://doi.org/10.1111/echo.14339
14. Mandoli G.E., Pastore M.C., Vasilijevaite K., Cameli P., D’Ascenzi F., Focardi M., et al. Speckle tracking stress echocardiography: a valuable diagnostic technique or a burden for everyday practice? Echocardiography. 2020; 37 (12): 2123–9. DOI: https://doi.org/10.1111/echo.14894
15. Mukhametgareeva A.V., Kashtalap V.V., Molchanov A.N., Vorob’ev A.S., Urvantseva I.A., Romashkin V.V., et al. The possibility to use ultrasound estimation of left ventricle strain in cardiology. Ul’yanovskiy mediko-biologicheskiy zhurnal [Medical and Biological Journal of Ul’yanovsk]. 2020; (3): 28–43. DOI: https://doi.org/10.34014/2227–1848–2020–3–28–43 (in Russian)
16. Quintana R.A., Bui L.P., Moudgil R., Palaskas N., Hassan S., Abe J.I., et al. Speckle-tracking echocardiography in cardio-oncology and beyond. Tex Heart Inst J. 2020; 47 (2): 96–107. DOI: https://doi.org/10.14503/THIJ‑18–6736
17. Nikiforov V.S., Nikishchenkova I.V. Modern possibilities of speckle tracking echocardiography in clinical practice. Ratsional’naya farmakoterapiya v kardiologii [Rational Pharmacotherapy in Cardiology]. 2017; 13 (2): 248–55. DOI: http://dx.doi.org/10.20996/1819–6446–2017–13–2–248–255 (in Russian)
18. Bazilevich A.V., Nelasov N. Yu., Sidorov R.V., Doltmurzieva N.S., Borshchev G.G., Pospelov D. Yu., et al. Modern possibilities of echocardiography in the surgical treatment of patients with coronary heart disease. Vestnik Natsional’nogo mediko-khirurgicheskogo Tsentra imeni N.I. Pirogova [Bulletin of the National Medical-Surgical Center named after N.I. Pirogov]. 2022; (17): 78–81. DOI: https://doi.org/10.25881/20728255_2022_17_2_78 (in Russian)
19. Serezhina E.K., Obrezan A.G. New imaging techniques in the diagnosis of heart failure with preserved ejection fraction. RMZh. Meditsinskoe obozrenie [RMJ. Medical Review]. 2019; 3 [1 (II)]: 52–6. (in Russian)
20. Cho E.J. Clinical implication (application) of measurement of LV function by three-dimensional speckle-tracking echocardiography: three-dimensional myocardial strain for the prediction of clinical events in patients with ST-segment elevation myocardial infarction. J Cardiovasc Imaging. 2022; 30 (3): 197–201. DOI: https://doi.org/10.4250/jcvi.2022.0059
21. Van Mil A.C., Drane A., Pearson J., Cockcroft J.R., McDonnell B.J., Stöhr E.J. Interaction of LV twist with arterial haemodynamics during localised, non-metabolic hyperaemia with and without blood flow restriction. Exp Physiol. 2016; 101: 509–20. DOI: https://doi.org/10.1113/EP085623
22. Stoichescu-Hogea G., Buleu F.N., Christodorescu R., Sosdean R., Tudor A., Ember A., et al. Contribution of global and regional longitudinal strain for clinical assessment of HFpEF in coronary and hypertensive patients. Medicina (Kaunas). 2021; 57 (12): 1372. DOI: https://doi.org/10.3390/medicina57121372
23. Hung C.L., Verma A., Uno H., Shin S., Bourgoun M., Hassaneinet A.H., et al.; VALIANT investigators. Longitudinal and circumferential strain rate, left ventricular remodeling, and prognosis after myocardial infarction. J Am Coll Cardiol. 2010; 56 (22): 1812–22. DOI: https://doi.org/10.1016/j.jacc.2010.06.044
24. Collier P., Phelan D., Klein A. A test in context: myocardial strain measured by speckle-tracking echocardiography. J Am Coll Cardiol. 2017; 69 (8): 1043–56. DOI: https://doi.org/10.1016/j.jacc.2016.12.012
25. Hassan A., Al Naffi K.O. The preference of using global longitudinal strain speckle tracking echo study over measurement of left ventricle ejection fraction (LVEF) in the early detection of subclinical systolic dysfunction in diabetic patients. Wiad Lek. 2021; 74 (12): 3195–98. PMID: 35058389.
26. Ren F., Xue T., Tang G., Zhang M., Zhao J., Chen Y., et al. Assessment of myocardial work of the left ventricle before and after PCI in patients with non-ST-Segment elevation acute coronary syndrome by pressure-strain loop technology. Comput Math Methods Med. 2022; 2022: 8026689. DOI: https://doi.org/10.1155/2022/8026689
27. Lustosa R.P., Fortuni F., Bijl P., Goedemans L., Mahdiui M.L., Montero-Cabezas J.M., Kostyukevich M.V., et al. Left ventricular myocardial work in the culprit vessel territory and impact on left ventricular remodelling in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention. Eur Heart J Cardiovasc Imaging. 2021; 22 (3): 339–47. DOI: https://doi.org/10.1093/ehjci/jeaa175
28. Galimskaya V.A., Babina A.V. New indicators of myocardial works in assessing the systolic function of the left ventricle. Vestnik Penzenskogo gosudarstvennogo universiteta [Bulletin of the Penza State University]. 2021; (3): 14–21. (in Russian).
29. D’Andrea A., Ilardi F., D’Ascenzi F., Bandera F., Benfari G., Esposito R., et al. Impaired myocardial work efficiency in heart failure with preserved ejection fraction. Eur Heart J Cardiovasc Imaging. 2021; 22 (11): 1312–20. DOI: https://doi.org/10.1093/ehjci/jeab153
30. Scărlătescu A.I., Barbălată T., Sima A.V., Stancu C., Niculescu L.S., Micheu M.M. miR‑146a‑5p, miR‑223–3p and miR‑142–3p as potential predictors of major adverse cardiac events in young patients with acute ST elevation myocardial infarction-added value over left ventricular myocardial work indices. Diagnostics (Basel). 2022; 12 (8): 1946. DOI: https://doi.org/10.3390/diagnostics12081946
31. Zhong X.F., Chen L.X., Liu L.X., Peng G.Y., Luo S.Y., Liu D.S., et al. Early detect left ventricular subclinical myocardial dysfunction in patients with systemic lupus erythematosus by a left ventricular pressure-strain loop. Lupus. 2022; 31 (5): 596–605. DOI: https://doi.org/10.1177/09612033221089150
32. El Mahdiui M., van der Bijl P., Abou R., Ajmone Marsan N., Delgado V., Bax J.J. Global left ventricular myocardial work efficiency in healthy individuals and patients with cardiovascular disease. J Am Soc Echocardiogr. 2019; 32: 1120–27. DOI: https://doi.org/10.1016/j.echo.2019.05.002
33. Coisne A., Fourdinier V., Lemesle G., Delsart P., Aghezzaf S., Lamblin N., et al. Clinical significance of myocardial work parameters after acute myocardial infarction. Eur Heart J Open. 2022; 2: 1–9. DOI: https://doi.org/10.1093/ehjopen/oeac037
34. Paolisso P., Gallinoro E., Mileva N., Moya A., Fabbricatore D., Esposito G., et al. Performance of non-invasive myocardial work to predict the first hospitalization for de novo heart failure with preserved ejection fraction. ESC Heart Fail. 2022; 9 (1): 373–84. DOI: https://doi.org/10.1002/ehf2.13740 Epub 2021 Nov 24.
35. Fortuni F., Butcher S.C., Kley F., Lustosa R.P., Karalis I., Weger A., et al. Left ventricular myocardial work in patients with severe aortic stenosis. J Am Soc Echocardiogr. 2021; 34 (3): 257–66. DOI: https://doi.org/10.1016/j.echo.2020.10.014
36. Wang T., Li L., Huang J., Fan L. Assessment of subclinical left ventricle myocardial dysfunction using global myocardial work in type 2 diabetes mellitus patients with preserved left ventricle ejection fraction. Diabetol Metab Syndr. 2022; 14 (1): 17. DOI: https://doi.org/10.1186/s13098–021–00781-x
37. Cui C., Li Y., Liu Y., Huang D., Hu Y., Wang Y., et al. Association between echocardiographic non-invasive myocardial work indices and myocardial fibrosis in patients with dilated cardiomyopathy. Front Cardiovasc Med. 2021; 8: 704251. DOI: https://doi.org/10.3389/fcvm.2021.704251
38. Meucci M.C., Butcher S.C., Galloo X., Velde E.T., Marsan N.A., Bax J.J., et al. Noninvasive left ventricular myocardial work in patients with chronic aortic regurgitation and preserved left ventricular ejection fraction. J Am Soc Echocardiogr. 2022; 35 (7): 703–11.e3. DOI: https://doi.org/10.1016/j.echo.2022.01.008
39. Liu Y., Cui C., Li Y., Wang Y., Hu Y., Bai M., et al. Predictive value of the echocardiographic noninvasive myocardial work index for left ventricular reverse remodeling in patients with multivessel coronary artery disease after percutaneous coronary intervention. Quant Imaging Med Surg. 2022; 12 (7): 3725–37. DOI: https://doi.org/10.21037/qims‑21–1066
40. Boe E., Skulstad H., Smiseth O.A. Myocardial work by echocardiography: a novel method ready for clinical testing. Eur Heart J Cardiovasc Imaging. 2019; 20 (1): 18–20. DOI: https://doi.org/10.1093/ehjci/jey15