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1

Soslow, Jonathan H., Emem Usoro, Li Wang, and David A. Parra. "Evaluation of tricuspid annular plane systolic excursion measured with cardiac MRI in children with tetralogy of Fallot." Cardiology in the Young 26, no. 4 (August 17, 2015): 718–24. http://dx.doi.org/10.1017/s1047951115001456.

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AbstractBackgroundAneurysmal dilation of the right ventricular outflow tract complicates assessment of right ventricular function in patients with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is commonly used to estimate ejection fraction. We hypothesised that tricuspid annular plane systolic excursion measured by cardiac MRI approximates global and segmental right ventricular function, specifically right ventricular sinus ejection fraction, in children with repaired tetralogy of Fallot.MethodsTricuspid annular plane systolic excursion was measured retrospectively on cardiac MRIs in 54 patients with repaired tetralogy of Fallot. Values were compared with right ventricular global, sinus, and infundibular ejection fractions. Tricuspid annular plane systolic excursion was indexed to body surface area, converted into a fractional value, and converted into published paediatric Z-scores.ResultsTricuspid annular plane systolic excursion measurements had good agreement between observers. Right ventricular ejection fraction did not correlate with the absolute or indexed tricuspid annular plane systolic excursion and correlated weakly with fractional tricuspid annular plane systolic excursion (r=0.41 and p=0.002). Segmental right ventricular function did not appreciably improve correlation with any of the tricuspid annular plane systolic excursion measures. Paediatric Z-scores were unable to differentiate patients with normal and abnormal right ventricular function.ConclusionsTricuspid annular plane systolic excursion measured by cardiac MRI correlates poorly with global and segmental right ventricular ejection fraction in children with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is an unreliable approximation of right ventricular function in this patient population.
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2

Grapsa, Julia. "Left Ventricular Ejection Fraction and Global Longitudinal Strain." Journal of the American College of Cardiology 72, no. 9 (August 2018): 1065–66. http://dx.doi.org/10.1016/j.jacc.2018.05.070.

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3

Naing, Pyi, Douglas Forrester, Nadarajah Kangaharan, Aruna Muthumala, Su Mon Myint, and David Playford. "Heart failure with preserved ejection fraction: A growing global epidemic." Australian Journal of General Practice 48, no. 7 (July 1, 2019): 465–71. http://dx.doi.org/10.31128/ajgp-03-19-4873.

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4

Standke, R., R. P. Baum, S. Tezak, D. Mildenberger, F. D. Maul, G. Hör, M. Kaltenbach, and H. Klepzig. "Vergleich von Belastungs- EKG und Radionuklid- Ventrikulographie bezüglich des Nachweises einer Myokardischämie bei isolierten Stenosen des Ramus interventricularis anterior." Nuklearmedizin 27, no. 02 (1988): 57–62. http://dx.doi.org/10.1055/s-0038-1628908.

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21 patients with LAD-stenoses of at least 70% and 21 patients with LAD- stenoses and additional intramural anterior wall infarctions were studied. 20 patients without heart disease or after successful transluminal coronary angioplasty and 18 patients with intramural anterior wall infarction after successful transluminal dilatation of the LAD (remaining stenosis maximal 30%) served as controls. The normal range of global and regional left ventricular ejection fraction response to exercise was defined based on the data of 25 further patients without relevant coronary heart disease. Thus, a decrease in global ejection fraction and regional wall motion abnormalities were judged pathological. All patients were comparable with respect to age, ejection fraction at rest and work load. Myocardial ischemia could be detected by the exercise ECG in 81 % of all patients without infarction and in 71 % of patients with infarction. The corresponding values for global left ventricular ejection fraction were 76% and 81 %, respectively, and for regional ejection fraction 95% in both groups. No false-positive exercise ECGs were observed in the healthy controls and 2 (11 %) in the corresponding group with intramural infarction. The global ejection fraction was pathological in 1 (5%) healthy subject without infarction and in 3 (17%) corresponding patients with infarction. Sectorial analysis revealed 5 and 22%, respectively. Our findings suggest that the exercise ECG has a limited sensitivity to detect myocardial ischemia in patients with isolated LAD-stenoses and intramural myocardial infarction. Radionuclide ventriculography yields pathological values more often; however, false-positive results also occur more frequently.
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Clemmensen, Tor Skibsted, Hans Eiskjær, Pernille B. Kofoed-Nielsen, Søren Høyer, and Steen Hvitfeldt Poulsen. "Case of Acute Graft Failure during Suspected Humoral Rejection with Preserved Ejection Fraction, but Severely Reduced Longitudinal Deformation Detected by 2D-Speckle Tracking." Case Reports in Transplantation 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/173589.

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This case displays limited utility of left ventricular ejection fraction to detect acute graft failure due to microvascular vasculopathy and suspected humoral rejection. Despite severe and progressive graft failure, clinically and by right heart catheterizations, left ventricular ejection fraction remained unchanged, indicating need of more reliable noninvasive methods for graft function surveillance. Global longitudinal strain relates to clinical heart failure, filling pressure, and cardiac index during suspected humoral rejection and microvascular dysfunction in this HTX patient. We suggest routine monitoring of graft function by global longitudinal strain as supplement to routine left ventricular ejection fraction and diastolic Doppler measurements.
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6

Borlaug, Barry A., Thomas P. Olson, Carolyn S. P. Lam, Kelly S. Flood, Amir Lerman, Bruce D. Johnson, and Margaret M. Redfield. "Global Cardiovascular Reserve Dysfunction in Heart Failure With Preserved Ejection Fraction." Journal of the American College of Cardiology 56, no. 11 (September 2010): 845–54. http://dx.doi.org/10.1016/j.jacc.2010.03.077.

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7

Chen, Yei-Tsung, Lee Lee Wong, Oi Wah Liew, and Arthur Mark Richards. "Heart Failure with Reduced Ejection Fraction (HFrEF) and Preserved Ejection Fraction (HFpEF): The Diagnostic Value of Circulating MicroRNAs." Cells 8, no. 12 (December 16, 2019): 1651. http://dx.doi.org/10.3390/cells8121651.

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Circulating microRNAs offer attractive potential as epigenetic disease biomarkers by virtue of their biological stability and ready accessibility in liquid biopsies. Numerous clinical cohort studies have revealed unique microRNA profiles in different disease settings, suggesting utility as markers with diagnostic and prognostic applications. Given the complex network of microRNA functions in modulating gene expression and post-transcriptional modifications, the circulating microRNA landscape in disease may reflect pathophysiological status, providing valuable information for delineating distinct subtypes and/or stages of complex diseases. Heart failure (HF) is an increasingly significant global health challenge, imposing major economic liability and health care burden due to high hospitalization, morbidity, and mortality rates. Although HF is defined as a syndrome characterized by symptoms and findings on physical examination, it may be further differentiated based on left ventricular ejection fraction (LVEF) and categorized as HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). The presenting clinical syndromes in HFpEF and HFrEF are similar but mortality differs, being somewhat lower in HFpEF than in HFrEF. However, while HFrEF is responsive to an array of therapies, none has been shown to improve survival in HFpEF. Herein, we review recent HF cohort studies focusing on the distinct microRNA profiles associated with HF subtypes to reveal new insights to underlying mechanisms and explore the possibility of exploiting these differences for diagnostic/prognostic applications.
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8

Sunthankar, Sudeep, David A. Parra, Kristen George-Durrett, Kimberly Crum, Joshua D. Chew, Jason Christensen, Frank J. Raucci, Meng Xu, James C. Slaughter, and Jonathan H. Soslow. "Tissue characterisation and myocardial mechanics using cardiac MRI in children with hypertrophic cardiomyopathy." Cardiology in the Young 29, no. 12 (November 26, 2019): 1459–67. http://dx.doi.org/10.1017/s1047951119002397.

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AbstractIntroduction:Distinguishing between hypertrophic cardiomyopathy and other causes ofleft ventricular hypertrophy can be difficult in children. We hypothesised that cardiac MRI T1 mapping could improve diagnosis of paediatric hypertrophic cardiomyopathy and that measures of myocardial function would correlate with T1 times and extracellular volume fraction.Methods:Thirty patients with hypertrophic cardiomyopathy completed MRI with tissue tagging, T1-mapping, and late gadolinium enhancement. Left ventricular circumferential strain was calculated from tagged images. T1, partition coefficient, and synthetic extracellular volume were measured at base, mid, apex, and thickest area of myocardial hypertrophy. MRI measures compared to cohort of 19 healthy children and young adults. Mann–Whitney U, Spearman’s rho, and multivariable logistic regression were used for statistical analysis.Results:Hypertrophic cardiomyopathy patients had increased left ventricular ejection fraction and indexed mass. Hypertrophic cardiomyopathy patients had decreased global strain and increased native T1 (−14.3% interquartile range [−16.0, −12.1] versus −17.3% [−19.0, −15.7], p < 0.001 and 1015 ms [991, 1026] versus 990 ms [972, 1001], p = 0.019). Partition coefficient and synthetic extracellular volume were not increased in hypertrophic cardiomyopathy. Global native T1 correlated inversely with ejection fraction (ρ = −0.63, p = 0.002) and directly with global strain (ρ = 0.51, p = 0.019). A logistic regression model using ejection fraction and native T1 distinguished between hypertrophic cardiomyopathy and control with an area under the receiver operating characteristic curve of 0.91.Conclusion:In this cohort of paediatric hypertrophic cardiomyopathy, strain was decreased and native T1 was increased compared with controls. Native T1 correlated with both ejection fraction and strain, and a model using native T1 and ejection fraction differentiated patients with and without hypertrophic cardiomyopathy.
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ITO, Koji, Azusa FUKUMITSU, Kikuko AKIMITSU, Machiko MURATA, Tomoyo OKUDA, Kayo KUROKAWA, Aki OGAWA, Masahiro MOHRI, and Hideo YAMAMOTO. "Increase in global function index in subjects with preserved left ventricular ejection fraction." Choonpa Igaku 44, no. 5 (2017): 439–45. http://dx.doi.org/10.3179/jjmu.jjmu.a.90.

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10

Patel, Jay, Rishi Rikhi, Muzna Hussain, Chadi Ayoub, Alan Klein, Patrick Collier, and Rohit Moudgil. "Global longitudinal strain is a better metric than left ventricular ejection fraction." Current Opinion in Cardiology 35, no. 2 (March 2020): 170–77. http://dx.doi.org/10.1097/hco.0000000000000716.

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11

Jenkins, C., T. Stanton, and T. Marwick. "What is the Best Predictor of Outcome: Ejection Fraction or Global Strain?" Heart, Lung and Circulation 19 (January 2010): S205. http://dx.doi.org/10.1016/j.hlc.2010.06.495.

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12

Survila, L., and E. Vaicekavicius. "Evaluation of left ventricle regional and global ejection fraction using ECG parameters." Journal of Electrocardiology 25, no. 3 (July 1992): 248–49. http://dx.doi.org/10.1016/0022-0736(92)90024-t.

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13

Marmor, Alon T., Alex Frankel, Michael Plich, Albert Satinger, and Dov Front. "Decrease in global ejection fraction after volume challenge in long-standing hypertension." American Heart Journal 111, no. 4 (April 1986): 746–51. http://dx.doi.org/10.1016/0002-8703(86)90110-9.

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14

Zambataro, Christopher A., Brian S. Ferguson, Rafael Shimkunas, Steven Tobia, Marcus Henze, and Carlos L. Del Rio. "Reduction of global longitudinal strain in rats with diastolic dysfunction and preserved ejection fraction: comparison against post-mi rats with reduced ejection fraction." Journal of Molecular and Cellular Cardiology 140 (March 2020): 44. http://dx.doi.org/10.1016/j.yjmcc.2019.11.105.

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15

Pandey, Amitabh C., Megan Pelter, Paul Montgomery, Ruth Kuo, Christine Shen, Rajbir Sidhu, David Lerner, et al. "CHANGES IN EJECTION FRACTION AND GLOBAL LONGITUDINAL STRAIN ASSESSMENT IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION AFTER THERAPY WITH SACUBITRIL/VALSARTAN." Journal of the American College of Cardiology 73, no. 9 (March 2019): 832. http://dx.doi.org/10.1016/s0735-1097(19)31439-1.

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Pannone, Luigi, Giulio Falasconi, Lorenzo Cianfanelli, Luca Baldetti, Francesco Moroni, Roberto Spoladore, and Pasquale Vergara. "Sudden Cardiac Death in Patients with Heart Disease and Preserved Systolic Function: Current Options for Risk Stratification." Journal of Clinical Medicine 10, no. 9 (April 22, 2021): 1823. http://dx.doi.org/10.3390/jcm10091823.

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Sudden cardiac death (SCD) is the leading cause of cardiovascular mortality in patients with coronary artery disease without severe systolic dysfunction and in heart failure with preserved ejection fraction. From a global health perspective, while risk may be lower, the absolute number of SCDs in patients with left ventricle ejection fraction >35% is higher than in those with severely reduced left ventricle ejection fraction (defined as ≤35%). Despite these observations and the high amount of available data, to date there are no clear recommendations to reduce the sudden cardiac death burden in the population with mid-range or preserved left ventricle ejection fraction. Ongoing improvements in risk stratification based on electrophysiological and imaging techniques point towards a more precise identification of patients who would benefit from ICD implantation, which is still an unmet need in this subset of patients. The aim of this review is to provide a state-of-the-art approach in sudden cardiac death risk stratification of patients with mid-range and preserved left ventricular ejection fraction and one of the following etiologies: ischemic cardiomyopathy, heart failure, atrial fibrillation or myocarditis.
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17

Aydrner, A., A. Oto, E. Oram, O. Gedik, C. F. Bekdik, A. Oram, S. Ugurlu, A. Karamehmetoglu, and T. Aras. "Left Ventricular Dysfunction and Blood Glycohemoglobin Levels in Young Diabetics." Nuklearmedizin 30, no. 05 (1991): 183–88. http://dx.doi.org/10.1055/s-0038-1629573.

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Left ventricular function including regional wall motion (RWM) was evaluated by 99mTc first-pass and equilibrium gated blood pool ventriculography and glycohemoglobin (HbA1c) blood levels determined by a quantitative column technique in 25 young patients with insulin-dependent diabetes mellitus without clinical evidence of heart disease, and in healthy controls matched for age and sex. Phase analysis revealed abnormal RWM in 19 of 21 diabetic patients. The mean left ventricular global ejection fraction, the mean regional ejection fraction and the mean 1/3 filling fraction were lower and the time to peak ejection, the time to peak filling and the time to peak ejection /cardiac cycle were longer in diabetics than in controls. We found high HbA1c levels in all diabetics. There was no significant difference between patients with and without retinopathy and with and without peripheral neuropathy in terms of left ventricular function and HbA1c levels.
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18

Lipiec, P., J. Wi niewski, and J. D. Kasprzak. "Should we search for linear correlations between global strain parameters and ejection fraction?" European Heart Journal - Cardiovascular Imaging 15, no. 11 (February 25, 2014): 1301. http://dx.doi.org/10.1093/ehjci/jeu020.

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19

Romano, Simone, Robert M. Judd, Raymond J. Kim, John F. Heitner, Dipan J. Shah, Chetan Shenoy, Kaleigh Evans, Benjamin Romer, Pablo Salazar, and Afshin Farzaneh-Far. "Feature-Tracking Global Longitudinal Strain Predicts Mortality in Patients With Preserved Ejection Fraction." JACC: Cardiovascular Imaging 13, no. 4 (April 2020): 940–47. http://dx.doi.org/10.1016/j.jcmg.2019.10.004.

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20

Kouris, Nikos T., Vassilis S. Kostopoulos, Georgia A. Psarrou, Peggy M. Kostakou, Chara Tzavara, and Christoforos D. Olympios. "Left ventricular ejection fraction and Global Longitudinal Strain variability between methodology and experience." Echocardiography 38, no. 4 (March 11, 2021): 582–89. http://dx.doi.org/10.1111/echo.15025.

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21

Jaglan, Akshar, Sarah Roemer, Ana Cristina Perez Moreno, and Bijoy K. Khandheria. "Myocardial work in Stage 1 and 2 hypertensive patients." European Heart Journal - Cardiovascular Imaging 22, no. 7 (March 10, 2021): 744–50. http://dx.doi.org/10.1093/ehjci/jeab043.

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Abstract Aims Myocardial work (MW) is a novel parameter that can be used in a clinical setting to assess left ventricular (LV) pressures and deformation. We sought to distinguish patterns of global MW index in hypertensive vs. non-hypertensive patients and to look at differences between categories of hypertension. Methods and results Sixty-five hypertensive patients (mean age 65 ± 13 years; 30 male) and 15 controls (mean age 38 ± 12 years; 7 male) underwent transthoracic echocardiography at rest. Hypertensive patients were subdivided into Stage 1 (n = 32) and Stage 2 (n = 33) hypertension based on 2017 American College of Cardiology guidelines. Exclusion criteria were suboptimal image quality for myocardial deformation analysis, reduced ejection fraction, valvular heart disease, intracardiac shunt, and arrhythmia. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency were estimated from LV pressure–strain loops utilizing proprietary software from speckle-tracking echocardiography. LV systolic and diastolic pressures were estimated using non-invasive brachial artery cuff pressure. Global longitudinal strain and LV ejection fraction were preserved between the groups with no statistically significant difference, whereas there was a statically significant difference between the control and two hypertension groups in GWI (P = 0.01), GCW (P &lt; 0.001), and GWW (P &lt; 0.001). Conclusion Non-invasive MW analysis allows better understanding of LV response under conditions of increased afterload. MW is an advanced assessment of LV systolic function in hypertension patients, giving a closer look at the relationship between LV pressure and contractility in settings of increased load dependency than LV ejection fraction and global longitudinal strain.
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van der Zedde, Janna, Thomas Oosterhof, Igor I. Tulevski, Hubert W. Vliegen, and Barbara J. M. Mulder. "Comparison of segmental and global systemic ventricular function at rest and during dobutamine stress between patients with transposition and congenitally corrected transposition." Cardiology in the Young 15, no. 2 (March 2005): 148–53. http://dx.doi.org/10.1017/s1047951105000326.

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The aim of the study was to evaluate segmental and global right ventricular function at rest and during stress in patients having a systemic morphologically right ventricle. We studied 17 patients after atrial correction for transposition, 13 with congenitally corrected transposition, and 11 age-matched controls using cardiovascular magnetic resonance at rest and during stress with dobutamine given at 15 micrograms per kilogram per minute. Blood was drawn to obtain levels of brain natriuretic peptide. Right ventricular ejection fraction was calculated, and wall-motion and wall-thickening were assessed, in 4 segments of a midventricular slice. The findings for the systemic right ventricle were compared to the left ventricle in controls. Patients with transposition showed a decreased ejection fraction at rest (57 percent versus 69 percent, p equal to 0.005), decreased wall motion of the anterior, lateral and septal wall (p less than 0.01, p less than 0.01, and p less than 0.01) and decreased thickening of the lateral wall (p less than 0.01). Patients with congenitally corrected transposition showed normal ejection fraction, wall thickening, and wall motion at rest. During dobutamine stress, we found no significant differences in wall motion and thickening between the two groups. Ejection fraction, also increased to comparable values during stress, at 67 percent versus 66 percent, p not being significant. In both groups, we observed similarly increased levels of brain natriuretic peptide (p equal to 0.02 and 0.03, respectively). We conclude that only patients with transposition showed segmental wall motion and wall thickening abnormalities at rest. After dobutamine stress, however, segmental and global right ventricular dysfunction was similar in both groups.
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23

Gottesman, Rebecca F., Maura A. Grega, Maryanne M. Bailey, Scott L. Zeger, William A. Baumgartner, Guy M. McKhann, and Ola A. Selnes. "Association between Hypotension, Low Ejection Fraction and Cognitive Performance in Cardiac Patients." Behavioural Neurology 22, no. 1-2 (2010): 63–71. http://dx.doi.org/10.1155/2010/725353.

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Background and Purpose:Impaired cardiac function can adversely affect the brain via decreased perfusion. The purpose of this study was to determine if cardiac ejection fraction (EF) is associated with cognitive performance, and whether this is modified by low blood pressure.Methods:Neuropsychological testing evaluating multiple cognitive domains, measurement of mean arterial pressure (MAP), and measurement of EF were performed in 234 individuals with coronary artery disease. The association between level of EF and performance within each cognitive domain was explored, as was the interaction between low MAP and EF.Results:Adjusted global cognitive performance, as well as performance in visuoconstruction and motor speed, was significantly directly associated with cardiac EF. This relationship was not entirely linear, with a steeper association between EF and cognition at lower levels of EF than at higher levels. Patients with low EF and low MAP at the time of testing had worse cognitive performance than either of these alone, particularly for the global and motor speed cognitive scores.Conclusions:Low EF may be associated with worse cognitive performance, particularly among individuals with low MAP and for cognitive domains typically associated with vascular cognitive impairment. Further care should be paid to hypotension in the setting of heart failure, as this may exacerbate cerebral hypoperfusion.
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Lin, Isabelle, Brian Yu, Haley Boyd, Sydney Winchester, Erin Caldwell, Katherine Lin, Betty Cornish, and Steve Lin. "THE FEASIBILITY OF GLOBAL LONGITUDINAL STRAIN IN CLINICAL PRACTICE AND RELATIONSHIP WITH EJECTION FRACTION." Journal of the American College of Cardiology 71, no. 11 (March 2018): A1716. http://dx.doi.org/10.1016/s0735-1097(18)32257-5.

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25

COMACANELLA, I., M. GOMEZ, L. SALAZAR, and F. GALLARDO. "Stress-induced increase in global and regional left ventricular ejection fraction after successful revascularization." Journal of Nuclear Cardiology 2, no. 2 (March 1995): S91. http://dx.doi.org/10.1016/s1071-3581(05)80450-7.

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26

RICART, Y. "Variability of the measurement of global and regional ejection fraction in dobutamide ventriculography test." Journal of Nuclear Cardiology 4, no. 1 (February 1997): S46. http://dx.doi.org/10.1016/s1071-3581(97)91295-2.

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27

Altman, M., L. Ernande, C. Bergerot, and G. Derumeaux. "Should we search for linear correlations between global strain parameters and ejection fraction? Reply." European Heart Journal - Cardiovascular Imaging 15, no. 11 (September 30, 2014): 1301–2. http://dx.doi.org/10.1093/ehjci/jeu187.

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28

Benyounes, Nadia, Sylvie Lang, Laurie Soulat-Dufour, Michaël Obadia, Olivier Gout, Gisèle Chevalier, and Ariel Cohen. "Can global longitudinal strain predict reduced left ventricular ejection fraction in daily echocardiographic practice?" Archives of Cardiovascular Diseases 108, no. 1 (January 2015): 50–56. http://dx.doi.org/10.1016/j.acvd.2014.08.003.

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Lejeune, Sibille, Clotilde Roy, Victor Ciocea, Alisson Slimani, Christophe de Meester, Mihaela Amzulescu, Agnes Pasquet, et al. "Right Ventricular Global Longitudinal Strain and Outcomes in Heart Failure with Preserved Ejection Fraction." Journal of the American Society of Echocardiography 33, no. 8 (August 2020): 973–84. http://dx.doi.org/10.1016/j.echo.2020.02.016.

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Yousfi, C., L. Abid, S. Ben Kahla, S. Charfeddine, F. Triki, R. Hammemi, and S. Kammoun. "Global longitudinal strain as a powerful prognosticator in heart failure with reduced ejection fraction." Archives of Cardiovascular Diseases Supplements 11, no. 3 (June 2019): e324. http://dx.doi.org/10.1016/j.acvdsp.2019.04.044.

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31

MacIver, David H., Ismail Adeniran, and Henggui Zhang. "Left ventricular ejection fraction is determined by both global myocardial strain and wall thickness." IJC Heart & Vasculature 7 (June 2015): 113–18. http://dx.doi.org/10.1016/j.ijcha.2015.03.007.

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Sullere, Vivek, Deepika Jain, Shivang Sullere, and Carmeline Anthony. "Global longitudinal strain, ejection fraction, effort tolerance and normal echocardiography measurements in healthy Indians." Indian Heart Journal 70, no. 5 (September 2018): 637–41. http://dx.doi.org/10.1016/j.ihj.2018.05.018.

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Mansell, Doyin S., Evelyn G. Frank, Nathaniel S. Kelly, Bruno Agostinho-Hernandez, James Fletcher, Vito D. Bruno, Eva Sammut, et al. "Comparison of the within-reader and inter-vendor agreement of left ventricular circumferential strains and volume indices derived from cardiovascular magnetic resonance imaging." PLOS ONE 15, no. 12 (December 15, 2020): e0242908. http://dx.doi.org/10.1371/journal.pone.0242908.

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Purpose Volume indices and left ventricular ejection fraction (LVEF) are routinely used to assess cardiac function. Ventricular strain values may provide additional diagnostic information, but their reproducibility is unclear. This study therefore compares the repeatability and reproducibility of volumes, volume fraction, and regional ventricular strains, derived from cardiovascular magnetic resonance (CMR) imaging, across three software packages and between readers. Methods Seven readers analysed 16 short-axis CMR stacks of a porcine heart. Endocardial contours were manually drawn using OsiriX and Simpleware ScanIP and repeated in both softwares. The images were also contoured automatically in Circle CVI42. Endocardial global, apical, mid-ventricular, and basal circumferential strains, as well as end-diastolic and end-systolic volume and LVEF were compared. Results Bland-Altman analysis found systematic biases in contour length between software packages. Compared to OsiriX, contour lengths were shorter in both ScanIP (-1.9 cm) and CVI42 (-0.6 cm), causing statistically significant differences in end-diastolic and end-systolic volumes, and apical circumferential strain (all p<0.006). No differences were found for mid-ventricular, basal or global strains, or left ventricular ejection fraction (all p<0.007). All CVI42 results lay within the ranges of the OsiriX results. Intra-software differences were found to be lower than inter-software differences. Conclusion OsiriX and CVI42 gave consistent results for all strain and volume metrics, with no statistical differences found between OsiriX and ScanIP for mid-ventricular, global or basal strains, or left ventricular ejection fraction. However, volumes were influenced by the choice of contouring software, suggesting care should be taken when comparing volumes across different software.
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34

Kalam, Kashif, Petr Otahal, and Thomas H. Marwick. "Prognostic implications of global LV dysfunction: a systematic review and meta-analysis of global longitudinal strain and ejection fraction." Heart 100, no. 21 (May 23, 2014): 1673–80. http://dx.doi.org/10.1136/heartjnl-2014-305538.

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35

Hee, L., A. Chen, C. Mussap, T. Nguyen, C. Juergens, H. Dimitri, J. French, D. Richards, and L. Thomas. "Is global longitudinal strain better than left ventricular ejection fraction for predicting infarct scar size?" Heart, Lung and Circulation 24 (2015): S347—S348. http://dx.doi.org/10.1016/j.hlc.2015.06.550.

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36

Stanton, T., R. Leano, and T. H. Marwick. "Prediction of Mortality from Global Longitudinal Strain: Comparison with Ejection Fraction and Wall Motion Scoring." Heart, Lung and Circulation 18 (2009): S46—S47. http://dx.doi.org/10.1016/j.hlc.2009.05.102.

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37

Beladan, Carmen C., and Andreea C. Popescu. "Prognostic value of global longitudinal strain versus ejection fraction: Time to pass on the torch?" International Journal of Cardiology 260 (June 2018): 133–34. http://dx.doi.org/10.1016/j.ijcard.2018.02.097.

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38

Pagourelias, Efstathios D., Jürgen Duchenne, Oana Mirea, Georgios Vovas, Johan Van Cleemput, Michel Delforge, Tatyana Kuznetsova, Jan Bogaert, and Jens-Uwe Voigt. "The Relation of Ejection Fraction and Global Longitudinal Strain in Amyloidosis: Implications for Differential Diagnosis." JACC: Cardiovascular Imaging 9, no. 11 (November 2016): 1358–59. http://dx.doi.org/10.1016/j.jcmg.2015.11.013.

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39

Egbe, Alexander C., William R. Miranda, Joseph Dearani, and Heidi M. Connolly. "Left Ventricular Global Longitudinal Strain Is Superior to Ejection Fraction for Prognostication in Ebstein Anomaly." JACC: Cardiovascular Imaging 14, no. 8 (August 2021): 1668–69. http://dx.doi.org/10.1016/j.jcmg.2021.01.036.

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40

Ibrahimi, Pranvera. "Global dyssynchrony correlates with compromised left ventricular filling and stroke volume but not with ejection fraction or QRS duration in HFpEF." International Cardiovascular Forum Journal 1, no. 3 (March 30, 2015): 147. http://dx.doi.org/10.17987/icfj.v1i3.40.

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Background and Aim: Mechanical global left ventricular (LV) dyssynchrony reflected as prolonged total isovolumic time<br />(t-IVT) has been introduced as a potential mechanism behind compromised stroke volume in heart failure (HF). It has also<br />been shown to be superior to other markers of dyssynchrony in predicting response to cardiac resynchronization therapy<br />(CRT), but its application in HF with preserved ejection fraction (HFpEF) remains unknown. The aim of this study was to<br />assess the role of t-IVT in explaining symptoms in HFpEF.<br />Methods: In 55 symptomatic HFpEF patients (age 60±9 years, NYHA class II-IV; LV EF ≥45%) and 24 age and gender<br />matched controls, a complete Doppler echocardiographic study was performed including mitral annulus peak systolic<br />excursion (MAPSE) and myocardial velocities as well as LV filling, outflow tract velocity time integral (VTI) and stroke volume<br />measurements. Global LV dyssynchrony was assessed by t-IVT [in s/min; calculated as: 60 - (total ejection time + total filling<br />time)], Tei index (t-IVT/ejection time) and pre-ejection time difference between LV and RV.<br />Results: Patients had reduced lateral and septal MAPSE (p=0.009 and p=0.01, respectively) lower lateral and septal s’<br />(p=0.002 and p=0.04, respectively) and e’ (p&lt;0.001, for both) velocities and higher E/e’ ratio (p=0.01) compared to controls.<br />They also had longer t-IVT (p&lt;0.001), higher Tei index (p=0.04), but similar pre-ejection time difference and LVEF to controls.<br />T-IVT correlated with LV filling time (r=0.44, p&lt;0.001), stroke volume (r=-0.41; p=0.002), MAPSE (lateral: r=-0.36, p=0.007 and<br />septal: r=-0.31; p=0.02), but not with LV mass index, LVEF, E/e’ ratio or QRS duration.<br />Conclusion: Patients with HFpEF have exaggerated global mechanical dyssynchrony shown by prolonged t-IVT, compared<br />with healthy age and gender matched controls. The relationship between t-IVT, LV filling and stroke volume suggests an<br />association, more important than with ejection fraction or electrical dyssynchrony. These results support the importance of<br />the individualistic approach for optimum HFpEF patient management.
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Bolog, Mihaela, Mihaela Dumitrescu, Florentina Romanoschi, Elena Pacuraru, and Alina Rapa. "Role of global longitudinal strain diastolic index in assessment of patients with suspected obstructive coronary artery disease and normal or mildly reduced ejection fraction." Romanian Journal of Cardiology 30, no. 2 (June 30, 2020): 222–29. http://dx.doi.org/10.47803/rjc.2020.30.2.222.

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Objective – To examine the utility of global longitudinal strain imaging diastolic index (SI-DI) in the assessment of patients with suspected obstructive coronary artery disease (CAD). Methods – We performed rest 2D standard echocardiography and strain imaging in 30 healthy subjects and in 148 patients with normal or mildly reduced ejection fraction and indication for coronarography for suspected obstructive CAD. Standard echocardiographic and strain parameters were analysed. Results – Global SI-DI was signifi cantly lower in the selected vs control group (p <0.001). After coronarography patients were divided in three subgroups: 74 patients with more than 50% obstruction in any major artery, 26 patients with previous revascularisation but no significant obstructive lesions at present and 48 patients without obstructive artery disease. Average global SI-DI was significantly lower in the subgroup with obstructive CAD vs the other two subgroups (p<0.05). Global SI-DI lower than 0.5 had a good sensitivity (84%) and a reasonable positive predictive value (52%) for detection of obstructive CAD. Conclusions – Global SI-DI is significantly lower in patients with obstructive CAD and normal or mildly reduced ejection fraction compared with normal subjects. A cut off value lower than 0.5 selects patients with a higher probability of obstructive CAD.
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42

Najmy, Shaneez, Rajan Paudel, Ajay Adhikari, Reeju Manandhar, Chandra Mani Adhikari, Ram Kishor Sah, Rabi Malla, Arun Maskey, Deewakar Sharma, and Sujeeb Rajbhandari. "Coronary Artery Disease prevalence in Heart Failure with Reduced Ejection Fraction." Nepalese Heart Journal 16, no. 2 (November 14, 2019): 29–34. http://dx.doi.org/10.3126/njh.v16i2.26314.

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Background and Aims: Even though heart failure (HF) is a major global health problem, studies on the prevalence and etiology of HF in Nepal are scant. Coronary artery disease (CAD) has been reported to be the etiology in 18% of HF presentations to the emergency department of a tertiary cardiac center in Nepal1. Present study evaluated the prevalence and characteristics of CAD in HF with reduced ejection fraction (HFrEF) with coronary angiography (CAG). Methods: In a prospective, observational study, conducted from June 2018 to May 2019, 95 patients with HFrEF undergoing CAG, at Shahid Gangalal National Heart Centre, were evaluated. Results: The mean age of the patients was 62.7±10.1 years, with 67% males. Obstructive CAD was present in 31(33%) with 48%, 39% and 13% having triple (TVD), single (SVD) and double vessel disease (DVD) respectively. Age ≥ 65 years, smokers, dyslipidemia, obesity, angina, indexed left ventricular end diastolic volume (iEDV), indexed LV systolic diameter (iLVIDs) and regional wall motion abnormality (RWMA) on echocardiography were predictors of CAD, among only which, smoking was the independent predictor of CAD. Conclusion: Our results suggest a lower prevalence of CAD in HFrEF than previously reported from developed countries, which may be due to a systematic angiography approach and exclusion of previous coronary events. We encourage clinicians to aggressively identify this co-morbidity as it has important treatment and prognostic implementations.
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Lillyblad, Matthew P. "Key Considerations For Integrating Sacubitril/Valsartan Into Chronic Heart Failure Management." Journal of the Minneapolis Heart Institute Foundation 2, no. 2 (December 2018): 34–43. http://dx.doi.org/10.21925/mplsheartjournal-d-18-00014.1.

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Heart failure with reduced ejection fraction remains a prevalent clinical syndrome associated with significant morbidity and mortality. Despite significant advances in heart failure with reduced ejection fraction pharmacotherapy, 5-year mortality remains 50%. Sacubitril/valsartan is a first-in-class angiotensin-receptor-neprilysin inhibitor, Food and Drug Administration–approved to reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic heart failure with reduced ejection fraction. Sacubitril/valsartan is recognized as a significant therapeutic advancement and endorsed by national guidelines, yet adoption into clinical practice has lagged across the United States. Recommendations for use differ greatly between the Prospective Comparison of Angiotensin-Receptor-Neprilysin Inhibitor with Angiotensin-Converting-Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure clinical trial, international guidelines, and the Food and Drug Administration-approved labeling, which can lead to uncertainty with prescribing. It is essential to establish an evidence-based, pragmatic approach to patient selection and management of sacubitril-valsartan facilitate integration into clinical practice. This review summarizes the pharmacology of sacubitril/valsartan, its known benefits and risks, and important considerations for incorporating sacubitril/valsartan into chronic heart failure management.
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Ayoub, Amal Mohamed, Viola William Keddeas, Yasmin Abdelrazek Ali, and Reham Atef El Okl. "Subclinical LV Dysfunction Detection Using Speckle Tracking Echocardiography in Hypertensive Patients with Preserved LV Ejection Fraction." Clinical Medicine Insights: Cardiology 10 (January 2016): CMC.S38407. http://dx.doi.org/10.4137/cmc.s38407.

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Background Early detection of subclinical left ventricular (LV) systolic dysfunction in hypertensive patients is important for the prevention of progression of hypertensive heart disease. Methods We studied 60 hypertensive patients (age ranged from 21 to 49 years, the duration of hypertension ranged from 1 to 18 years) and 30 healthy controls, all had preserved left ventricular ejection fraction (LVEF), detected by two-dimensional speckle tracking echocardiography (2D-STE). Results There was no significant difference between the two groups regarding ejection fraction (EF) by Simpson's method. Systolic velocity was significantly higher in the control group, and global longitudinal strain was significantly higher in the control group compared with the hypertensive group. In the hypertensive group, 23 of 60 patients had less negative global longitudinal strain than −19.1, defined as reduced systolic function, which is detected by 2D-STE (subclinical systolic dysfunction), when compared with 3 of 30 control subjects. Conclusion 2D-STE detected substantial impairment of LV systolic function in hypertensive patients with preserved LVEF, which identifies higher risk subgroups for earlier medical intervention.
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Akramova, E. G., and Е. V. Vlasova. "Assessment of left ventricular contractility in acute inferior wall myocardial infarction by speckle tracking echocardiography." Russian Medical Inquiry 5, no. 4 (2021): 169–75. http://dx.doi.org/10.32364/2587-6821-2021-5-4-169-175.

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Aim: to assess the results of speckle tracking echocardiography (STE) in patients of working age with acute inferior wall myocardial infarction (MI) in the early period after coronary stenting. Patients and Methods: STE was performed using EPIQ-7 Ultrasound Machine (Philips, USA) in 55 patients with acute inferior wall MI one week after percutaneous coronary intervention and 29 healthy individuals of working age. Patients with acute inferior wall MI were divided into two subgroups, i.e., with (n=45) or without (n=10) areas of local contractile impairment (dyskinesia, akinesia, hypokinesia). Results: the most common cause of MI was the occlusion of the right coronary artery (82.4% in subgroup 1 and 60% in subgroup 2) in multivascular involvement (84.4% and 90%. respectively). In patients with local contractile impairment, reduced left ventricular ejection fraction (EF) was reported in 28.9%, global longitudinal strain in 86.7%, and global circular strain in 76.7%. Meanwhile, in patients without local contractile impairment, left ventricular ejection fraction (LV EF) was within normal ranges, global longitudinal strain was reported in 100% and global circumferential strain in 70%. The presence and severity of local dysfunction did not affect the reduction in segmental strain (median varied from -9% to -15%). In inferior wall MI, the abnormal regional longitudinal strain of 6 LV segments (basal and mid inferoseptal, inferior, and inferolateral) was reported in both hypokinesia and normokinesia. Conclusions: ultrasound evaluation of systolic LV function using STE is characterized by greater diagnostic value compared to the measurement of EF only and objectifies the efficacy of surgery. Quantitative assessment of the recovery of both global and local systolic contractility is another advantage of STE allowing for personalized treatment. KEYWORDS: inferior wall myocardial infarction, echocardiography, speckle tracking technology, percutaneous coronary intervention, ejection fraction. FOR CITATION: Akramova E.G., Vlasova Е.V. Assessment of left ventricular contractility in acute inferior wall myocardial infarction by speckle tracking echocardiography. Russian Medical Inquiry. 2021;5(4):169–175 (in Russ.). DOI: 10.32364/2587-6821-2021-5-4-169-175.
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Midtbø, Helga, Anne Grete Semb, Knut Matre, Tore K. Kvien, and Eva Gerdts. "Disease activity is associated with reduced left ventricular systolic myocardial function in patients with rheumatoid arthritis." Annals of the Rheumatic Diseases 76, no. 2 (June 7, 2016): 371–76. http://dx.doi.org/10.1136/annrheumdis-2016-209223.

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ObjectivesDisease activity has emerged as a new, independent risk factor for cardiovascular disease in patients with rheumatoid arthritis (RA). We tested if disease activity in RA was associated with lower left ventricular (LV) systolic function independent of traditional cardiovascular risk factors.MethodsEchocardiographic assessment was performed in 78 patients with RA having low, moderate or high disease activity (Simplified Disease Activity Index (SDAI) >3.3), 41 patients in remission (SDAI ≤3.3) and 46 controls, all without known cardiac disease. LV systolic function was assessed by biplane Simpson ejection fraction, stress-corrected midwall shortening (scMWS) and global longitudinal strain (GLS).ResultsPatients with active RA had higher prevalence of hypertension and diabetes compared with patients in remission and controls (both p<0.05). LV ejection fraction (endocardial function) was normal in all three groups, while mean scMWS and GLS (myocardial function) were reduced in patients with RA with active disease compared with patients with RA in remission (95±18% vs 105±17% and −18.9±3.1% vs −20.6±3.5%, respectively, both p<0.01). Patients with RA in remission had similar scMWS and GLS as the controls. In multivariable analyses, having active RA was associated with lower GLS (β=0.21) and scMWS (β=−0.22, both p<0.05), both reflecting lower LV systolic myocardial function, independent of cardiovascular risk factors and LV ejection fraction. Classification of RA disease activity by other disease activity composite scores yielded similar results.ConclusionsActive RA is associated with lower LV systolic myocardial function despite normal ejection fraction and independent of traditional cardiovascular risk factors.
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Dorobantu, Lucian Florin, Ovidiu Chioncel, Alexandra Pasare, Dorin Lucian Usurelu, Ioan Serban Bubenek-Turconi, and Vlad Anton Iliescu. "An Unusual Association: Right Atrial Myxoma and Severe Left Ventricular Dysfunction. Case Report and Review of the Literature." Heart Surgery Forum 17, no. 6 (January 13, 2015): 285. http://dx.doi.org/10.1532/hsf98.2014420.

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Myxomas comprise 50% of all benign cardiac tumors in adults, with the right atrium as their second most frequent site of origin. Surgical resection is the only effective therapeutic option for patients with these tumors. The association between right atrial myxomas and severe left ventricular systolic dysfunction is extremely rare and makes treatment even more challenging. This was the case for our patient, a 47-year-old male with a right atrial mass and a severely impaired left ventricular function, with a 20% ejection fraction. Global enlargement of the heart was also noted, with moderate right ventricular dysfunction. The tumor was successfully excised using the on-pump beating heart technique, with an immediate postoperative improvement of the left ventricular ejection fraction to 35%. The technique proved useful, with no increased risk to the patient.
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48

Yu, Yaohan, Sisi Yu, Xuepei Tang, Haibo Ren, Shuhao Li, Qian Zou, Fakui Xiong, Tian Zheng, and Lianggeng Gong. "Evaluation of left ventricular strain in patients with dilated cardiomyopathy." Journal of International Medical Research 45, no. 6 (June 6, 2017): 2092–100. http://dx.doi.org/10.1177/0300060517712164.

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Objective Dilated cardiomyopathy (DCM) can cause structural and functional changes in the left ventricle (LV). In this study, we evaluated whether cardiac magnetic resonance tissue-tracking (MR-TT) can be applied to the detection of LV abnormalities in patients with DCM. Methods We used MR-TT to analyze the global peak radial strain (GPRS), global peak circumferential strain (GPCS), and global peak longitudinal strain (GPLS) in every segment of the LV in 23 patients with DCM and 25 controls. The LV ejection fraction was also measured as a function indicator. Results Compared with the controls, the GPRS, GPCS, and GPLS were significantly reduced in patients with DCM, indicating global LV function impairment in all directions. We also identified a significant linear correlation between the GPRS, GPCS, and GPLS and the LV ejection fraction, indicating that LV function relies on coordinated wall motion from all directions. Moreover, we found that patients with DCM had a significantly reduced magnitude of the PRS, PCS, and PLS in most segments at different levels, indicating impaired myocardial function in most LV regions. Conclusions Our results demonstrate that LV myocardial strain in patients with DCM can be sensitively detected by MR-TT (not only the global LV function changes but also the segmental strain), which can help to identify the injured segment at an early stage and guide clinical treatment.
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49

Cherniuk, S. V. "Predictors of unfavorable course of acute myocarditis with reduced left ventricular ejection fraction." Reports of Vinnytsia National Medical University 23, no. 2 (June 27, 2019): 251–56. http://dx.doi.org/10.31393/reports-vnmedical-2019-23(2)-13.

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Early prediction of myocarditis clinical course still remains one of the actual tasks of cardiological science, which has a significant practical value. The purpose of the study was to determine the predictors of unfavorable course of myocarditis with reduced ejection fraction (EF) of the left ventricle (LV) on the basis of follow-up during 24 months. The study included 90 patients with acute myocarditis and reduced LV EF, who were examined in the first month after the disease onset, after 6, 12 and 24 months of follow-up. All patients underwent for echocardiography, Holter monitoring of the electrocardiogram and cardiac magnetic resonance imaging. Statistical processing of the results was performed using the Excel XP software (Місrosoft Office, USA) and Statistica for Windows v. 6.0 (Statsoft, USA). It was found that restoration of cardiac contractility in patients with myocarditis and reduced LV EF began with an increase in the index of LV longitudinal global systolic strain, which occurred 6 months after the debut of the disease and was associated with a decrease in the number of LV segments affected by the inflammatory process, and a significant increase of LV EF and a decrease of LV end-diastolic volume were observed only 1 year after the disease onset. The predictors of cardiovascular events in patients with acute myocarditis during the next 24 months from the onset of the disease, were detected in the 1st month from the debut of the disease and included following pathological changes: value of the LV EF ≤ 30%; reduction of LV longitudinal global systolic strain ≤ 7.0%; evidence of non-sustained ventricular tachycardia, presence of inflammatory changes in ≥6 LV segments, presence of delayed enhancement in ≥ 5 LV segments. Prospects for further research are the creation of registries of patients with myocarditis on the basis of multicenter clinical trial results on a large number of patients surveyed in order to improve diagnosis, prediction of clinical course and identification of early diagnostic markers of cardiovascular events and quantitative risk assessment of their development.
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Bayram, Ednan, Oktay Gulcu, Ugur Aksu, Emrah Aksakal, Oguzhan Birdal, and Kamuran Kalkan. "Evaluating the Association Between the Three Different Ejection Fraction Measurement Techniques and Left Ventricle Global Strain." Eurasian Journal of Medicine 50, no. 3 (November 16, 2018): 173–77. http://dx.doi.org/10.5152/eurasianjmed.2018.17409.

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