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San Raffaele Cimena, Italy

Mondillo S.,University of Siena | Galderisi M.,University of Naples Federico II | Mele D.,University of Ferrara | Cameli M.,University of Siena | And 12 more authors.
Journal of Ultrasound in Medicine | Year: 2011

Speckle-tracking echocardiography has recently emerged as a quantitative ultrasound technique for accurately evaluating myocardial function by analyzing the motion of speckles identified on routine 2-dimensional sonograms. It provides non-Doppler, angle-independent, and objective quantification of myocardial deformation and left ventricular systolic and diastolic dynamics. By tracking the displacement of the speckles during the cardiac cycle, strain and the strain rate can be rapidly measured of fline after adequate image acquisition. Data regarding the feasibility, accuracy, and clinical applications of speckle-tracking echocardiography are rapidly accumulating. This review describes the fundamental concepts of speckle-tracking echocardiography, illustrates how to obtain strain measurements using this technique, and discusses their recognized and developing clinical applications. © 2011 by the American Institute of Ultrasound in Medicine. Source

Blondheim D.S.,Noninvasive Cardiology Unit | Blondheim D.S.,Technion - Israel Institute of Technology | Vassilenko L.,Hillel Yaffe Medical Center | Vassilenko L.,Technion - Israel Institute of Technology | And 14 more authors.
Journal of Cardiology | Year: 2016

Objective: Clinical follow-up of aortic dimensions is performed interchangeably by multi-detector computed tomography (MDCT) and by cardiac echocardiography (ECHO). This study assesses the relationship between measurements of the aortic diameter by MDCT and ECHO at various predetermined locations using several methods. Methods: The aortic diameter was measured at 6 locations between the aortic annulus and the aortic arch in 49 patients who underwent both MDCT and ECHO. Measurements were performed by three methods: internal-to-internal edge (INT), external-to-internal edge (MIX), and external-to-external edge (EXT). Measurements by MDCT and ECHO were made by an experienced radiologist and cardiologist, respectively, both blinded to results and images from the other modality. Results: The average aortic diameter at all locations was significantly different between the MDCT and ECHO by all three methods (INT: 30.0 ± 5.8 mm vs. 27.8 ± 5.9 mm; MIX: 31.5 ± 5.8 mm vs. 30.8 ± 5.8 mm; EXT: 32.9 ± 6.6 mm vs. 33.8 ± 6.5 mm, p < 0.002 for all). While mean absolute differences between INT and EXT methods were similar (3.5 ± 3.1 mm and 3.4 ± 2.7 mm, respectively), the absolute difference using the MIX method was significantly smaller (3.1 ± 2.8 mm; p < 0.001 for INT vs. MIX; p < 0.05 for EXT vs. MIX). Conclusions: There is considerable variability between MDCT and ECHO measurements of the ascending aorta. Measuring the aortic diameter by the MIX provides the closest measurements and is advised for long-term follow-up. © 2015 Japanese College of Cardiology. Source

Cameli M.,University of Siena | Lisi M.,University of Siena | Giacomin E.,University of Siena | Caputo M.,University of Siena | And 5 more authors.
Echocardiography | Year: 2011

Background: Speckle tracking echocardiography (STE) is a novel method for the angle-independent and objective quantification of myocardial deformation; it has recently evolved, enabling the quantification of longitudinal myocardial left atrial (LA) deformation dynamics. To investigate the effects of chronic mitral regurgitation (MR) on these functional atrial indices, we analyzed LA function by STE in a group of asymptomatic patients with chronic degenerative MR. Methods: The study population included 36 patients with mild MR, 38 with moderate MR, and 42 with severe MR. 52 age-matched controls were also recruited. Global peak atrial longitudinal strain (global PALS) was measured in all subjects by averaging all atrial segments. Results: Age, gender, and LV ejection fraction in all pathological groups were comparable to those in the controls. Global PALS was higher in the mild MR group (46.7 ± 9.1%) in comparison with the controls (40.5 ± 6.2%; P < 0.001); instead global PALS was lower in the moderate MR group (25.7 ± 7.1%) and further reduced in the severe MR group (13.2 ± 5.2%) in comparison with the controls (40.5 ± 6.2%; overall P < 0.0001 by ANOVA, P < 0.05 for all pairwise comparisons). In multivariate analysis, E/Em ratio emerged as the principal independent determinant of global PALS. Conclusions: Our study provides new insight for the LA function analysis in response to different degrees of MR, showing that STE measurements of LA longitudinal strain may be considered a promising tool for the early detection of impairment of LA compliance in patients with asymptomatic chronic MR. © 2011, Wiley Periodicals, Inc. Source

Mele D.,Azienda Ospedaliera Universitaria | Agricola E.,Noninvasive Cardiology Unit | Monte A.D.,Azienda Ospedaliera Universitaria | Galderisi M.,University of Naples Federico II | And 8 more authors.
International Journal of Cardiology | Year: 2013

Background: In patients with ischemic heart failure undergoing cardiac resynchronization therapy (CRT) the underlying myocardial substrate at the left ventricle (LV) pacing site may affect CRT response. However, the effect of delivering the pacing stimulus remote, adjacent to or over LV transmural scar tissue (TST) identified by echocardiography is still unknown. Methods: First, 35 patients with healed myocardial infarction (57 ± 11 years) were prospectically studied to demonstrate the capability of echocardiographic end-diastolic wall thickness (EDWT) to identify LV-TST as defined by delayed enhancement magnetic resonance imaging (DE-MRI). Subsequently, in 136 patients (65 ± 10 years) who underwent CRT, EDWT was retrospectively evaluated at baseline. The LV catheter placement was defined over, adjacent to and remote from TST if pacing was delivered at a scarred segment, at a site 1 segment adjacent to or remote from scarred segments. CRT response was defined as LV end-systolic volume (ESV) decrease by at least 10% after 6 months. Results: A EDWT ≤ 5 mm identified TST at DE-MRI with 92% sensitivity and 96% specificity. In the 76 CRT responders, less overall and posterolateral TST segments and more segments paced remote from TST areas were found. At the multivariate regression analysis, the number of TST segments and scar/pacing relationship showed a significant association with CRT response. Conclusions: In addition to LV global scar burden, CRT response relates also to the myocardial substrate underlying pacing site as evaluated by standard echocardiography. This information may expand the role of echocardiography to guide pacing site avoiding pacing at TST areas. © 2011 Elsevier Ireland Ltd. Source

Losi M.-A.,University of Naples Federico II | Nistri S.,CMSR Veneto Medica Altavilla Vicentina | Galderisi M.,University of Naples Federico II | Betocchi S.,University of Naples Federico II | And 11 more authors.
Cardiovascular Ultrasound | Year: 2010

Hypertrophic cardiomyopathy (HCM) is one of the most common inherited cardiomyopathy. The identification of patients with HCM is sometimes still a challenge. Moreover, the pathophysiology of the disease is complex because of left ventricular hyper-contractile state, diastolic dysfunction, ischemia and obstruction which can be coexistent in the same patient. In this review, we discuss the current and emerging echocardiographic methodology that can help physicians in the correct diagnostic and pathophysiological assessment of patients with HCM. © 2010 Losi et al; licensee BioMed Central Ltd. Source

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