Hidemaro Sato

Gifu Heart Center

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Masanori Kawasaki

Gifu Heart Center

Shinya Minatoguchi

Gifu University

Ryuhei Tanaka

Saitama Medical University

Toshiyuki Noda

Gifu Prefectural General Medical Center

Shingo Minatoguchi

Gifu University

Koji Ono

Gifu Prefectural General Medical Center

Maki Nagaya

Gifu Prefectural General Medical Center

Takashi Yoshizane

Gifu Prefectural General Medical Center

Sachiro Watanabe

Gifu Prefectural General Medical Center

Shigeki Sawada

Okinawa Prefectural Chubu Hospital

Cooperative Institutions

Istituti di Ricovero e Cura a Carattere Scientifico

Gifu University

Centro Cardiologico Monzino

Institute of Cardiology

Inserm

Gifu Prefectural General Medical Center

University of Padua

Imperial College London

Centro de Investigación en Red en Enfermedades Cardiovasculares

University of Milan

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P3548Noninvasive estimation of left ventricular diastolic function in patients with hypertension and normal ejection fraction using 3-dimensional speckle tracking echocardiography

European Heart Journal (2019)

Shinya Minatoguchi Ryou Tanaka Takashi Yoshizane T Deguchi Hidemaro Sato

Abstract Background Left ventricular (LV) relaxation (eTau) and pulmonary capillary wedge pressure (ePCWP) were reported to be estimated by speckle tracking echocardiography (STE). LV camber stiffness (e-c stiffness) may be estimated with the use of 2 diastolic pressure-volume coordinates. The minimum diastolic pressure (mP) is reported to have a strong correlation with Tau. Purpose We sought to examine the impact of hypertension on LV diastolic function and LA properties and to elucidate the feature of hypertensive heart failure with preserved EF (HFpEF). Methods The e', E/e', Tau, PCWP, LVEDP, LV stiffness, LAV, LA emptying function (LAEF) and LA strain were examined in 53 controls (age 66±11), 136 hypertensive patients (HTN) with normal EF (69±11) and 39 HFpEF (77±14). ePCWP and estimated EDP (eEDP) was calculated as previously reported. Tau was calculated as isovolumic relaxation time/(ln 0.9 x systolic blood pressure − ln PCWP). Myocardial stiffness (e-m stiffness) was estimated as LVED stress/LV strain. LV c-stiffness was calculated as LV pressure change (from mP to EDP) obtained by catheterization divided by LV volume change. Estimated LV c-stiffness (e-c-stiffness) was noninvasively obtained using e-mP and e-EDP. The eTau, eEDP and e-mP by STE were validated by catheterization (n=126). Results The mP had a good correlation with Tau (r=0.70, p<0.01). The eTau, eEDP and e-mP by STE had a good correlation with those by catheterization (r=0.75, 0.63 and 0.70, p<0.01). Multivariate analysis revealed that ePCWP and LA strain were independent predictors of HFpEF. LV diastoric function Variables Control HTN HFpEF LVEF, % 68±6 68±8 63±9*+ LV longitudinal strain x (s–1) 19.1±3.0 16.8±4.3* 14.5±5.1*+ E/e' 9.2±2.6 11.6±4.5* 15.9±7.9*+ eTau, ms 35±12 48±17* 59±17*+ ePCWP, mmHg 7.3±2.7 8.3±4.3 15.0±4.4*+ eLVEDP, mmHg 9.4±2.2 10.4±3.5 15.9±3.7*+ LV e-myocardial stiffness, kdynes/cm 0.56±0.25 0.69±0.56 1.27±0.71*+ LV e-chamber stiffness, mmHg/ml 0.19±0.06 0.20±0.08 0.36±0.19*+ Maximum LAVI, ml/m2 42±15 50±21* 68±17*+ Total LAEF, % 55±7 51±11 36±12*+ LA peak strain 41±15 40±17 19±8*+ *p<0.05 vs Control, +p<0.05 vs HTN. Conclusion We demonstrated that LV diastolic function in HTN may be accurately and noninvasively evaluated by STE.

Speckle tracking echocardiography

Preload

Isovolumic relaxation time

Pulmonary wedge pressure

Afterload

10.1093/eurheartj/ehz745.0411

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Poster Session 1

EP Europace (2011)

Abhishek Deshmukh Shashi Sharma F. G. Gobal Shelly Singla P. H. Hebbar

was higher in the NRG (p 0.70 was the more accurate RT-MCE value to predict LV regional recovery with positive predictive value of 70% and negative predictive value of 56% (p<0.05). Conclusion: RT-MCE is valuable for predicting recovery of LV function after reperfused AMI.

10.1093/europace/eur220

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Left atrial structure and function assessed by two- and three-dimensional speckle tracking echocardiography in hypertension: a comparative study with computed tomography

European Heart Journal (2013)

Takuya Watanabe Masanori Kawasaki Hidemaro Sato Maki Nagaya Shinya Minatoguchi

Purpose: Using speckle tracking echocardiography (STE), emerging attention has been brought to the left atrium (LA) which is very complex due to close coupling with left ventricle (LV) and affected by diastolic function. Although two-dimensional STE (2D-STE) using the assumption of Simpson's method has been recently used to evaluate LA structure and function, three-dimensional STE (3D-STE) has a major advantage of the improvement of accuracy in the evaluation of cardiac chamber volume without any geometrical assumption. Methods: We evaluated LA volume (LAV) and function in mild hypertensive patients (HTN) (age, 69±10, BP: 131±8/80±7mmHg, n=35) and normal subjects (age, 55±18, n=35) by 2D-STE and 3D-STE and validated the accuracy of 2D-STE and 3D-STE by comparison with 3D-CT as a gold standard (n=30). Phasic LAV, emptying function (EF) and strain were measured by 2D-STE and 3D-STE. Using 2D-STE, LA parameters were measured in apical 2, 3 and 4 chamber view. LV mass, ejection fraction as a systolic function and E/e' and pulmonary capillary wedge pressure (PCWP) as a diastolic function were measured. PCWP was estimated as 10.7 – 12.4 × log (LA active EF/minimum LAV index) as we reported. Results: The intraobserver and the interobserver correlation coefficient and viability in maximum LAV by 3D-STE were 0.99 and 1.4±6.0%, and 0.99 and 0.2±4.5%, respectively. There was a good relation between LAV by 3D-STE and 2D-STE in apical 2, 3 and 4 chamber view and the average of these 3 views (r=0.74, 0.80, 0.79 and 0.84, p<0.01, respectively). There was a better correlation in LAV between 3D-CT and 3D-STE (r=0.98, p<0.01) than 2D-STE (r=0.92, p<0.01). 2D-STE in apical 4-chamber view overestimated maximum LAV compared to 3D-STE (56±19 vs. 51±13ml, p<0.05), resulted in overestimation of LA total EF (50±12 vs. 46±9%, p<0.05). LA passive EF in HTN assessed by 3D-STE was decreased associated with increased LV mass and E/e' compared to normal (16±7 vs. 22±8%, 109±29 vs. 91±19g/m2, 10.0±2.1 vs. 7.4±1.4, p<0.05, respectively) despite no difference in PCWP between two groups (7.3±2.1 vs. 7.0±1.9mmHg). LA active EF in HTN was increased associated with increased pre-atrial contraction LAV (35±9 vs. 30±10%, 29±8 vs. 22±6ml/m2, p<0.05, respectively). Conclusion: 3D-STE allowed more accurate measurement of phasic LAV and LAEF than 2D-STE and had a high reproducibility. 3D-STE showed that LA conduit function in HTN was decreased associated with increased LV mass and that LA booster pump function was increased associated with increased pre-atrial contraction LAV, suggesting Frank-Starling law in LA in mild HTN.

Speckle tracking echocardiography

Pulmonary wedge pressure

10.1093/eurheartj/eht308.p1120

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Evaluation of systolic and diastolic properties of hypertensive heart failure using speckle-tracking echocardiography with high volume rates

Heart and Vessels (2017)

Shingo Minatoguchi Masanori Kawasaki Ryuhei Tanaka Takashi Yoshizane Koji Ono

Systole

Speckle tracking echocardiography

Pulmonary wedge pressure

10.1007/s00380-017-0995-2

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Citations (12)

Abstract 14700: Impact of Hemodialysis on Left Ventricular Systolic and Diastolic Properties Before and After Dialysis: a Three-dimensional Speckle Tracking Echocardiography Study

Circulation (2016)

Masanori Kawasaki Ryuhei Tanaka Hidemaro Sato Shingo Minatoguchi Tatsuya Kariya

Introduction: Most patients with dialysis have left ventricular (LV) hypertrophy and fibrosis which may result in heart failure. Although estimation of LV function and fluid status is helpful in tr...

Speckle tracking echocardiography

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Abstract 11663: The Features of Hypertensive Heart Failure With Preserved Ejection Fraction Assessed by 3-Dimensional Speckle Tracking Echocardiography With Novel Software

Circulation (2014)

Noriaki Sato Masanori Kawasaki Michael R. Zile Ryuhei Tanaka Shingo Minatoguchi

Background: Left ventricular (LV) pressure overload causes hypertrophy (LVH), which leads to reduced LV relaxation and compliance and results in heat failure with preserved ejection fraction (HFpEF...

Speckle tracking echocardiography

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Abstract 11961: Impact of Left Ventricular Systolic Stress on Contractility in Hypertension Assessed by One-beat Three-dimensional Speckle Tracking Echocardiography With High Volume Rates

Circulation (2015)

Itta Kawamura Masanori Kawasaki Ryuhei Tanaka Rina Otake Yoshie Nakano

Background: Left ventricular hypertrophy (LVH) is known as compensative mechanism of LV against pressure overload to reduce LV stress and maintain systolic performance. However, the relationship between LV systolic stress and strain or torsion that reflects contractility assessed by 3-dimensional speckle tracking echocardiography with high volume rates (3D-STE) has not been examined. We sought to evaluate the impact of LV systolic stress on LV contractility in hypertension (HTN). Methods: A total of 162 subjects {131 HTN patients and 31 controls (age 65±12)} were enrolled. HTN were divided into 3 groups: 47 HTN patients without LVH (age 67±12), 47 HTN patients with LVH (age 70±11) and 37 patients with hypertensive heart failure (HHF) (age 74±15). We examined LV longitudinal, circumferential and radial peak strain, LV strain rate at systole (SR) and LV torsion by 3D-STE with 70-80vps. LV systolic stress was calculated as LV end systolic radius x systolic blood pressure / thickness. Results: LV strain and SR in 3 directions and torsion decreased in HHF (longitudinal strain; control: -19±3, HTN without LVH: -18±4, HTN with LVH: -17±4, HHF: -13±4*. Torsion; 1.4±0.2, 1.4±0.3, 1.5±0.3, 1.2±0.2* °/cm, *p<0.05 vs control) associated with increased systolic stress (129±24, 141±36, 143±40, 164±51* mmHg). There was correlation between LV systolic stress and longitudinal, radial and circumferential peak strain (r=0.18, p=0.024, r=-0.22, p=0.005 and r=0.18, p=0.021, respectively) and between LV stress and LV radial SR (r=-0.1.9, p=0.018) in total subjects. There was not a significant correlation between LV systolic stress and strain or SR in 3 directions in controls. Significant correlation was found between LV stress and circumferential strain or torsion in HHF (r=0.43, r=-0.34, p<0.05), but not between LV stress and longitudinal or radial strain in HHF. Conclusion: Reduction of LV contractility assessed by LV strain, SR-S and torsion was associated with LV stress. In HHF only circumferential strain and torsion were decreased associated with increased LV stress, suggesting that the beginning of reduction in circumferential strain and torsion after deterioration of longitudinal and radial contractility due to increased systolic stress may be responsible for HHF.

Contractility

Beat (acoustics)

Speckle tracking echocardiography

Stress Echocardiography

Systole

10.1161/circ.132.suppl_3.11961

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Abstract 11979: Noninvasive Evaluation of the Feature of Hypertensive Heart Failure using One-beat Real-time Three-dimensional Speckle Tracking Echocardiography With High Volume Rates

Circulation (2015)

Masanori Kawasaki Ryuhei Tanaka Shingo Minatoguchi Hidemaro Sato Kijun Nagata

Background: Left ventricular (LV) properties in hypertension (HTN) could be deteriorated by pressure overload that causes LV hypertrophy (LVH) resulting in hypertensive heart failure (HHF). However, transition from HTN to HHF and the feature of HHF have not been noninvasively examined. Methods: We examined 31 controls (age 69±9), 47 HTN without LVH: LVH (-) (age 70±9), 47 HTN with LVH: LVH (+) (age 69±6) and 37 HHF patients (age 71±11) by 3-dimensional speckle tracking echocardiography with volume rate of 70-80vps (3D-STE). LV contractility and relaxation were assessed by radial strain rate (SR) at systole (SR-S) and isovolumic relaxation (SR-IVR). LV torsion was measured by 3D-STE. Pulmonary capillary wedge pressure (PCWP) was calculated as 10.8 - 12.4 x log (left atrial active emptying function / left atrial minimum volume index) as we reported. Tau was estimated as isovolumic relaxation time / (ln 0.9 x systolic blood pressure - ln PCWP). LV stress was calculated as LV radius x pressure / thickness. LV stiffness was estimated as diastolic stress / strain. Results: LV SR-S and SR-IVR in HHF decreased (SR-S; control: 2.5±0.8, LVH (-): 2.6±0.6, LVH (+): 2.5±0.7, HHF: 1.9±0.4* s-1. SR-IVR; -0.8±0.5, -0.7±0.4, -0.7±0.4*, -0.5±0.4* s-1, *p<0.05 vs control). LV ejection fraction (EF) in HHF decreased (66±9, 69±6, 67±11, 51±14* %) associated with reduced torsion (1.4±0.2, 1.4±0.3, 1.5±0.3, 1.2±0.2* °/cm) and increased systolic stress. Tau was prolonged even in LVH (-) (29±12, 41±14*, 47±14*, 65±19*, msec). LV stiffness increased in LVH (+) and HHF (0.5±0.2, 0.6±0.4, 0.6±0.3*, 1.5±1.2*) associated with elevated PCWP (7±2, 8±4, 9±4*, 15±5* mmHg) and diastolic stress (16±5, 19±12, 21±12, 32±13* dynes/cm2). On multivariate logistic analysis, ePCWP was the parameter that showed the strongest independent factor associated with HHF. Using 11mmHg as a cutoff value, sensitivity and specificity to predict HHF in the HTN group was 83 and 81%. Conclusion: Noninvasive 3D-STE examination revealed that LV contractility and relaxation were decreased in HHF and that HHF had more reduced EF, prolonged Tau and increased stiffness associated with reduced torsion, increased systolic and diastolic stress and PCWP. PCWP was an independent determinant of HHF in echo parameters.

Beat (acoustics)

Speckle tracking echocardiography

Feature tracking

Heart beat

Feature (linguistics)

Tracking (education)

10.1161/circ.132.suppl_3.11979

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A case with cardiac sarcoidosis. Significance of the effect of steroids on the reversion of advanced atrioventricular block and myocardial scintigraphic abnormalities.

PubMed (1990)

Nobuya Fujita Michiaki Hiroe Yasutomo Suzuki Hidemaro Sato Yoichi Inoue