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Relationship Between Left Ventricular Twisting Motion and LV Dyssynchrony in 3-Dimentional Speckle Tracking Imaging
S166 Journal of Cardiac Failure Vol. 20 No. 10S October 2014 serum N-3 PUFA concentrations and the changes of echocardiographic parameters during 6-month observation period was evaluated. The correlation analysis demonstrated that the ratio of EPA to AA (EPA/AA) at baseline negatively correlated with left atrial diameter index (LADI) (R50.534, p50.0151), while other echocardiographic parameters showed no significant correlation with baseline N-3 PUFA. Conclusion: Our results demonstrated that the low levels of serum EPA/AA at baseline may promote left atrial remodeling following onset of AMI.
O-121 The Beneficial Effect of Transcatheter Atrial Septal Defect Closure on Ventricular Remodeling: Analysis of Three-dimensional Echocardiography MICHIYO YAMANO, TETSUHIRO YAMANO, TAKESHI NAKAMURA, NAOHIKO NAKANISHI, HIROKAZU SHIRAISHI, AKIYOSHI MATSUMURO, HIROYUKI YAMADA, TAKESHI SHIRAYAMA Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine Objective: We assessed right and left ventricular (RV and LV, respectively) remodeling process after transcatheter atrial septal defect (ASD) closure. Methods: Three-dimensional echocardiography was performed for patients undergoing transcatheter ASD closure before; and two days, one month, and six months after the procedure. Ventricular volumes were analyzed using 4D RVFunction (TomTec) for RV and EchoPAC software (GE) for LV. Results: The RV volume decreased and LV volume increased immediately after the closure. Although the degree of remodeling was gradually reduced, both ventricular volumes tended to change during six months follow-up period (Table). Thus, stroke volume augmentation was consistently observed throughout the period. Conclusion: In patients undergoing transcatheter ASD closure, both RV and LV favorable remodeling process progressed gradually and continued at least six months after the procedure.
RV enddiastolic volume (mL) RV endsystolic volume (mL) LV enddiastolic volume (mL) LV endsystolic volume (mL) LV stroke volume (mL)
Before Procedure (n567)
Twoday follow up (n566)
Onemonth follow up (n553)
Six month followup (n547)
ANOVA p
106 6 38*,y,z
87 6 36y,z
78 6 26
73 6 23
!0.0001
43 6 13y,z
42 6 16y,z
36 6 12
34 6 12
!0.0001
58 6 15*,y,z
66 6 20y,z
74 6 17
79 6 22
!0.0001
21 6 7y,z
23 6 7y,z
25 6 7
25 6 8
!0.0001
37 6 10*,y,z
44 6 14y,z
50 6 12
54 6 15
!0.0001
*p!0.05 versus two days follow-up. y p!0.05 versus one month follow-up. z p!0.05 versus six months follow-up.
O-122 Usefulness of Diastolic Myocardial Stiffness Assessed by Diastolic Wall Strain in Assessing Cardiac Involvement in Light-chain Amyloidosis MASAYOSHI YAMAMOTO, YOSHIHIRO SEO, NAOTO KAWAMATSU, NORIAKI SUGANO, AKIKO ATSUMI, TOMOKO MACHINO, KIMI SATO, TOMOKO ISHIZU, KAZUTAKA AONUMA Cardiovascular Division, University of Tsukuba Aim: To evaluate usefulness of diastolic myocardial stiffness assessed by diastolic wall strain (DWS) in assessing cardiac involvement (CI) in light-chain (AL) amyloidosis. Methods: Patients with biopsy-proven AL amyloidosis (n521), hypertrophic cardiomyopathy (HCM, n515), hypertension (HT, n515) and normal control (n515) were enrolled. DWS was measured by the previous manner using M-mode echocardiography. Results: Eleven patients in AL amyloidosis (55%) had CI. As shown in figures, DWS in amyloidosis without CI was similar to normal control and significantly lower than HCM and amyloidosis with CI. DWS cut off value ! 0.22 clearly detected CI in AL amyloidosis. Conclusion: Diastolic myocardial stiffness by DWS has a potential to identify cardiac involvement in AL amyloidosis.
O-123 Septal Myectomy with Aortic Valve Replacement in Patietns with Sigmoid Septum is Associated with Improvement of Post-operative Left Ventricular Function TOMOKO KATO2, MASAKI RYOKO MORIMOTOICHIKAWA1, MARUYAMA1, SAKIKO MIYAZAKI1, HIROTOSHI OHMURA1, KENJI KUWAKI2, ATSUSHI AMANO2, HIROYUKI DAIDA1 1 Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan, 2 Department of Cardiovascular Sugery, Juntendo University, Tokyo, Japan Background: Septal myectomy in patients with hypertrophic cardiomyopathy with left ventricular outflow obstruction is a promissing procedure for improving survival and symptom relief. However, the effect of expanding the indications for septal myectomy in patients with sigmoid septum with aortic valve replacemnet (AVR) have not been elucidated. Purpose: We investigated the effect of concomitant septal myoectomy with AVR on post-operative outcome based on echocardiographic findings. Methods: We reviewed 16 patients received AVR with septal myoectomy (14 female, mean age 7566 year-old) and age/sex/body-size matched 26 patients undergoing AVR-alone. Conventional echo parameters obtained from all patients and strain parameters from a subset of 10 patients in each group were analyzed. Results: Post-operative LV ejection fraction (LVEF) was better in myoectomy group than AVR-alone group (p50.0417). None of the patients in myoectomy group showed post-operative low LVEF difined as !50%, whereas 5 patients in AVR-alone group (19.2%) showed low LVEF (p!0.001). Basal septum strain improved in myectomy group (paired-t p50.012) but not in AVR-alone group (p50.056). Postoperative intubation time tended to be shorter and the blood loss tended to be smaller in the myoectomy group. Conclusions: Septal myoectomy with AVR is safe may be associated with improvement of LVEF, which may induced by the basal septal contractile normalization. Further investigation would be required to evaluate its long-term efficacy.
O-124 Relationship Between Left Ventricular Twisting Motion and LV Dyssynchrony in 3-Dimentional Speckle Tracking Imaging SHOHEI FUJIWARA1, KAZUO KOMAMURA1,2, MITSURU MASAKI1, AKIYO EGUCHI1, MASATAKA SUGAHARA1, KUMIKO MASAI1, AKIKO GODA1, SHINICHI HIROTANI1, TOSHIAKI MANO1, TOHRU MASUYAMA1 1 Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan, 2Osaka Clinic, Takeda Pharmaceutical Company Limited Background: Although the extent of left ventricular (LV) dyssynchrony can be measured accurately using 3-dimentional speckle-tracking (3DT), its detection is difficult. We hypothesized that detection of LV twisting motion could be a simpler substitute for detection of dyssynchrony. Methods: We examined 25 patients with sick sinus syndrome implanted with pacemakers. The acute changes in wall motion following the switch from atrial to ventricular pacing were assessed. 3DT was used to measure LV twisting motion (Twist and Torsion) and dyssynchrony during each pacing. Twist was the difference between apex and basal rotation. Torsion was the Twist per LV length. Dyssynchrony was the maximum standard deviation of time to peak systolic area strains in 16 LV segments to the heart cycle (%). Results: The switch from atrial to ventricular pacing increased dyssynchrony (7.761.0 to 12.564.0%, respectively; p! 0.0001). However, the switch decreased Twist and Torsion (15.3 61.9 to 10.5 62.5 ; 1.7 /cm60.5 /cm to 1.2 /cm 60.5 /cm, respectively, p! 0.0001, p!0.005). There was a significant correlations between changes in dyssynchrony and changes in Torsion (r 5 -0.65, p!0.05) but not in Twist. Conclusion: Changes in LV torsion assessed by 3DT imaging reflected the changes in LV mechanical dyssynchrony.
O-121 The Beneficial Effect of Transcatheter Atrial Septal Defect Closure on Ventricular Remodeling: Analysis of Three-dimensional Echocardiography MICHIYO YAMANO, TETSUHIRO YAMANO, TAKESHI NAKAMURA, NAOHIKO NAKANISHI, HIROKAZU SHIRAISHI, AKIYOSHI MATSUMURO, HIROYUKI YAMADA, TAKESHI SHIRAYAMA Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine Objective: We assessed right and left ventricular (RV and LV, respectively) remodeling process after transcatheter atrial septal defect (ASD) closure. Methods: Three-dimensional echocardiography was performed for patients undergoing transcatheter ASD closure before; and two days, one month, and six months after the procedure. Ventricular volumes were analyzed using 4D RVFunction (TomTec) for RV and EchoPAC software (GE) for LV. Results: The RV volume decreased and LV volume increased immediately after the closure. Although the degree of remodeling was gradually reduced, both ventricular volumes tended to change during six months follow-up period (Table). Thus, stroke volume augmentation was consistently observed throughout the period. Conclusion: In patients undergoing transcatheter ASD closure, both RV and LV favorable remodeling process progressed gradually and continued at least six months after the procedure.
RV enddiastolic volume (mL) RV endsystolic volume (mL) LV enddiastolic volume (mL) LV endsystolic volume (mL) LV stroke volume (mL)
Before Procedure (n567)
Twoday follow up (n566)
Onemonth follow up (n553)
Six month followup (n547)
ANOVA p
106 6 38*,y,z
87 6 36y,z
78 6 26
73 6 23
!0.0001
43 6 13y,z
42 6 16y,z
36 6 12
34 6 12
!0.0001
58 6 15*,y,z
66 6 20y,z
74 6 17
79 6 22
!0.0001
21 6 7y,z
23 6 7y,z
25 6 7
25 6 8
!0.0001
37 6 10*,y,z
44 6 14y,z
50 6 12
54 6 15
!0.0001
*p!0.05 versus two days follow-up. y p!0.05 versus one month follow-up. z p!0.05 versus six months follow-up.
O-122 Usefulness of Diastolic Myocardial Stiffness Assessed by Diastolic Wall Strain in Assessing Cardiac Involvement in Light-chain Amyloidosis MASAYOSHI YAMAMOTO, YOSHIHIRO SEO, NAOTO KAWAMATSU, NORIAKI SUGANO, AKIKO ATSUMI, TOMOKO MACHINO, KIMI SATO, TOMOKO ISHIZU, KAZUTAKA AONUMA Cardiovascular Division, University of Tsukuba Aim: To evaluate usefulness of diastolic myocardial stiffness assessed by diastolic wall strain (DWS) in assessing cardiac involvement (CI) in light-chain (AL) amyloidosis. Methods: Patients with biopsy-proven AL amyloidosis (n521), hypertrophic cardiomyopathy (HCM, n515), hypertension (HT, n515) and normal control (n515) were enrolled. DWS was measured by the previous manner using M-mode echocardiography. Results: Eleven patients in AL amyloidosis (55%) had CI. As shown in figures, DWS in amyloidosis without CI was similar to normal control and significantly lower than HCM and amyloidosis with CI. DWS cut off value ! 0.22 clearly detected CI in AL amyloidosis. Conclusion: Diastolic myocardial stiffness by DWS has a potential to identify cardiac involvement in AL amyloidosis.
O-123 Septal Myectomy with Aortic Valve Replacement in Patietns with Sigmoid Septum is Associated with Improvement of Post-operative Left Ventricular Function TOMOKO KATO2, MASAKI RYOKO MORIMOTOICHIKAWA1, MARUYAMA1, SAKIKO MIYAZAKI1, HIROTOSHI OHMURA1, KENJI KUWAKI2, ATSUSHI AMANO2, HIROYUKI DAIDA1 1 Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan, 2 Department of Cardiovascular Sugery, Juntendo University, Tokyo, Japan Background: Septal myectomy in patients with hypertrophic cardiomyopathy with left ventricular outflow obstruction is a promissing procedure for improving survival and symptom relief. However, the effect of expanding the indications for septal myectomy in patients with sigmoid septum with aortic valve replacemnet (AVR) have not been elucidated. Purpose: We investigated the effect of concomitant septal myoectomy with AVR on post-operative outcome based on echocardiographic findings. Methods: We reviewed 16 patients received AVR with septal myoectomy (14 female, mean age 7566 year-old) and age/sex/body-size matched 26 patients undergoing AVR-alone. Conventional echo parameters obtained from all patients and strain parameters from a subset of 10 patients in each group were analyzed. Results: Post-operative LV ejection fraction (LVEF) was better in myoectomy group than AVR-alone group (p50.0417). None of the patients in myoectomy group showed post-operative low LVEF difined as !50%, whereas 5 patients in AVR-alone group (19.2%) showed low LVEF (p!0.001). Basal septum strain improved in myectomy group (paired-t p50.012) but not in AVR-alone group (p50.056). Postoperative intubation time tended to be shorter and the blood loss tended to be smaller in the myoectomy group. Conclusions: Septal myoectomy with AVR is safe may be associated with improvement of LVEF, which may induced by the basal septal contractile normalization. Further investigation would be required to evaluate its long-term efficacy.
O-124 Relationship Between Left Ventricular Twisting Motion and LV Dyssynchrony in 3-Dimentional Speckle Tracking Imaging SHOHEI FUJIWARA1, KAZUO KOMAMURA1,2, MITSURU MASAKI1, AKIYO EGUCHI1, MASATAKA SUGAHARA1, KUMIKO MASAI1, AKIKO GODA1, SHINICHI HIROTANI1, TOSHIAKI MANO1, TOHRU MASUYAMA1 1 Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan, 2Osaka Clinic, Takeda Pharmaceutical Company Limited Background: Although the extent of left ventricular (LV) dyssynchrony can be measured accurately using 3-dimentional speckle-tracking (3DT), its detection is difficult. We hypothesized that detection of LV twisting motion could be a simpler substitute for detection of dyssynchrony. Methods: We examined 25 patients with sick sinus syndrome implanted with pacemakers. The acute changes in wall motion following the switch from atrial to ventricular pacing were assessed. 3DT was used to measure LV twisting motion (Twist and Torsion) and dyssynchrony during each pacing. Twist was the difference between apex and basal rotation. Torsion was the Twist per LV length. Dyssynchrony was the maximum standard deviation of time to peak systolic area strains in 16 LV segments to the heart cycle (%). Results: The switch from atrial to ventricular pacing increased dyssynchrony (7.761.0 to 12.564.0%, respectively; p! 0.0001). However, the switch decreased Twist and Torsion (15.3 61.9 to 10.5 62.5 ; 1.7 /cm60.5 /cm to 1.2 /cm 60.5 /cm, respectively, p! 0.0001, p!0.005). There was a significant correlations between changes in dyssynchrony and changes in Torsion (r 5 -0.65, p!0.05) but not in Twist. Conclusion: Changes in LV torsion assessed by 3DT imaging reflected the changes in LV mechanical dyssynchrony.