assessing-intracardiac-vortices-with-high-frame-rate-echocardiography

Assessing Intracardiac Vortices with High Frame-Rate Echocardiography-Derived Blood Speckle Imaging in Newborns

The left ventricle (LV) has a unique pattern of hemodynamic filling. During diastole, a rotational body or ring of fluid known as a vortex is formed due ...

University of Newcastle

Evaluation of sensitive myocardial mechanics with speckle tracking echocardiography (STE) across the lifespan may reveal early indicators of cardiovascular disease (CVD) risk. Epicardial adipose tissue (EAT) and left ventricular (LV) myocardial dyssynchrony; subclinical risk-factors of CVD, are of particular clinical interest. However, the evolution of EAT and LV-dyssynchrony across the lifespan, and their influence on myocardial dysfunction remains unclear. We aimed to establish a profile of the healthy aging-heart using conventional, tissue-Doppler imaging (TDI) and speckle-tracking echocardiography (STE), while also exploring underlying contributions from EAT and LV-dyssynchrony towards LV myocardial mechanics, independent of blood biology.

Increased myocardial dysfunction, dyssynchrony, and epicardial fat across the lifespan in healthy males.

A vortex is a rotational fluid structure formed by shearing of fluid layers. It forms during diastole in the left ventricle (LV) and helps redirect flow to the LV outflow tract for ejection, optimizing energy conservation. The aim of this study was to demonstrate the feasibility of detecting and analyzing LV vortices using a new ultrasound technique known as blood speckle imaging (BSI).

Left ventricular vortex formation in preterm infants assessed by blood speckle imaging.

Diastolic dysfunction is primarily an echocardiographic diagnosis. Its clinical counterpart is diastolic heart failure, where the heart has difficulty to fill at normal pressure and the patient develops signs of pulmonary edema. Although diastolic dysfunction is common in adults, limited information is available in preterm infants. The aim of this study is to explore left ventricular diastolic dysfunction and diastolic heart failure in preterm infants and describe clinical manifestations in this population. This is a retrospective observational study in preterm infants < 30 weeks' gestation who received an echocardiography in the first 4 weeks after birth. Diastolic dysfunction was graded using a population-specific adapted version of the adult recommendations for the evaluation of left ventricular diastolic function by echocardiography. Left ventricular diastolic dysfunction was absent, indeterminate, and definite in 82%, 14%, and 4% of the 168 echocardiograms analyzed, and is associated with increased respiratory signs and respiratory deterioration at 48 h before echocardiogram. In seven infants, diastolic heart failure was diagnosed with both ultrasound and clinical signs. The cumulative risk of diastolic dysfunction increased with the increasing postnatal age and a patent ductus arteriosus. Evidence of left ventricular diastolic dysfunction on echocardiography is relatively common in preterm infants, while the left ventricular diastolic heart failure is less frequent. Prolonged exposure to volume load was the most common cause.

Left Ventricular Diastolic Dysfunction and Diastolic Heart Failure in Preterm Infants.

This study aims to determine the association between clinical patterns of early respiratory disease and diastolic dysfunction in preterm infants.

The association between patterns of early respiratory disease and diastolic dysfunction in preterm infants.

Relaxation, restoring forces, myocardial stiffness and atrial function determine left ventricular (LV) diastolic function. This study aims to provide a comprehensive assessment of diastolic function in preterm infants using conventional echocardiography and speckle tracking imaging and determine the diagnostic accuracy of various algorithms to detect high left atrial pressure (LAP).

Article	Year
Increased myocardial dysfunction, dyssynchrony, and epicardial fat across the lifespan in healthy males. BMC cardiovascular disorders\| PubMed ID: 25086592	2014
Left ventricular vortex formation in preterm infants assessed by blood speckle imaging. Echocardiography (Mount Kisco, N.Y.)\| PubMed ID: 31169946	2019
Left Ventricular Diastolic Dysfunction and Diastolic Heart Failure in Preterm Infants. Pediatric cardiology\| PubMed ID: 31598743	2019
The association between patterns of early respiratory disease and diastolic dysfunction in preterm infants. Journal of perinatology : official journal of the California Perinatal Association\| PubMed ID: 36823313	2023
Echocardiography algorithms to assess high left atrial pressure and grade diastolic function in preterm infants. Echocardiography (Mount Kisco, N.Y.)\| PubMed ID: 37658834	2023

Edward Crendal

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