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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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Quantitative longitudinal peak systolic strain in the detection of left ventricular wall motion abnormalities: an analysis of our daily echocardiographic practice
Session:
Posters (Sessão 4 - Écran 1) - Imagem 2 - Ecocardiografia 1
Speaker:
Diana De Campos
Congress:
CPC 2022
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Diana Decampos; Carolina Saleiro; Ana Botelho; Rogério Teixeira; Ana Rita m. Gomes; João Lopes; Lino Gonçalves
Abstract
<p>Background: Regional wall motion abnormalities (RWMA) of the left ventricle (LV) are an important indicator of disease. Two-dimensional speckle-tracking echocardiography (2D-STE), which is less operator-dependent, has been proposed for this purpose. We aimed to assess if RMWA were correlated with segmental longitudinal peak systolic strain (LPSS) values in patients with coronary artery disease.</p> <p>Methods: A total of 106 consecutive patients (78.2% male) aged 57±12 years clinically evaluated for an non-ST segment elevation acute coronary syndrome were studied. RWMA were assessed by trained personnel and wall motion score index (WMSI) was calculated. Segmental LPSS values were categorized has normal/mildly (≥-12.6%), moderately (-8.1 and -12.5%) and severely (≤-8.0%) reduced. Global longitudinal strain (GLS) was averaged from three standard longitudinal views. Linear regression analysis was used to estimate the relation between WMSI and average GLS. Pearson correlations were used to estimate the correlation between qualitative assessment of RMWA and segmental LPSS.</p> <p>Results: A total of 1216 segments were successfully tracked (average LPSS -15.71±4.03%). WMSI showed a significant correlation with GLS with a coefficient of determination of 0.49 and a beta coefficient of 0.704 (<em>P</em>=0.000). On naked eye evaluation, of 1309 segments, 80.2%, 14.3%, and 5.5% segments were diagnosed as normal, hypokinesis, and akinesis, respectively. On strain analysis, of the 1216 tracked segments, 77.2% had normal/mildly, 13.5% had moderately and 9.3% had severely reduced strain values. Level of agreement between segmental motion classification and segmental LPSS values was moderate to strong in basal (r=0.24-0.55, <em>P</em><0.05), mid (r=0.39-0.66, <em>P</em><0.01) and apical levels (r=0.45-0.64, <em>P</em><0.01).</p> <p>Conclusions: Qualitative assessment of RWMA had significant moderate-to-strong correlation with LPSS, suggesting that segmental LPSS values may help to differentiate between normal and abnormal left ventricular segments at basal, mid and apical levels. Segmental LPSS assessment can be a useful tool for training residents.</p>
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