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Novel Echocardiographic Techniques for the Assessment of Cardiovascular Disease

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A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 31 July 2024 | Viewed by 3547

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Special Issue Editor

Dr. Konstantinos Katogiannis

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Guest Editor

2nd Cardiology Department, National and Kapodistrian University of Athens, General Hospital Attikon, Chaidari 12462, Greece
Interests: preventive cardiology; diabetes and the heart; microcirculation; coronary circulation; endothelial function; cardioncology

Special Issue Information

Dear Colleagues,

Echocardiography is a noninvasive and reproducible method that may aid in the diagnosis and risk stratification in patients with cardiovascular disease or cardiovascular risk factors.

The aim of this Special Issue is to analyze the echocardiographic techniques which can detect early alteration in cardiac function, provide additive information for diagnosis or prognosis and reveal response to therapy.

There is a wide spectrum of topics suitable for this Special Issue, provided they highlight novel echocardiographic technologies, such as speckle tracking echocardiography, contrast echocardiography, 3D echocardiography, stress echocardiography and coronary flow reserve by doppler echocardiography. More precisely, COVID-19, inflammatory disease, diabetes, hypertension, hyperlipidemia and smoking are risk factors for cardiovascular disease, and novel echocardiography techniques may detect subtle myocardial dysfunction in these groups of patients. Moreover, in patients with coronary artery disease, valvular disease, pericardial disease and cardiomyopathies, regardless of the presence of heart failure, echocardiography has additive prognostic value on top of clinical situation and serum biomarkers. Furthermore, the echocardiographic assessment of aorta and peripheral vasculature is of great importance for the detailed evaluation of each patient.

The papers that we are soliciting are research articles and reviews. Case reports might be included if they are of special interest and if the echocardiography is crucial for patient handling.

Dr. Konstantinos Katogiannis
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

speckle tracking
myocardial deformation
3D echocardiography
exercise/stress echocardiography
contrast echocardiography
coronary flow reserve
diastolic dysfunction

Published Papers (4 papers)

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Research

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10 pages, 310 KiB

Open AccessArticle

Altered Arterial Stiffness, Ventricular–Arterial Coupling and Troponin Levels in Patients with Systemic Lupus Erythematosus

by Nikolaos P. E. Kadoglou, Alexandriani Dimopoulou, Evangelia Gkougkoudi and Konstantinos Parperis

Medicina 2024, 60(5), 821; https://doi.org/10.3390/medicina60050821 - 16 May 2024

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Abstract

Introduction: Systemic Lupus Erythematosus (SLE) is an autoimmune disease associated with an increased risk of cardiovascular diseases (CVDs), leading to elevated mortality rates among patients. We aimed to evaluate the levels of cardio–ankle vascular index (CAVI), global longitudinal strain (GLS), ventricular–arterial coupling (VAC), and high-sensitivity cardiac troponin I (hsTnI) in SLE patients and to explore their relationship with clinical parameters. Methods: This cross-sectional study enrolled 82 SLE patients without evident cardiac or kidney impairment and 41 age- and sex-matched healthy controls. We comparatively evaluated CAVI, GLS, VAC, and hsTnI between SLE patients and controls, and we assessed their association among SLE patients with disease activity based on the SELENA–SLEDAI Activity Index. Multivariate regression analysis was performed to identify independent predictors of CAVI and hsTnI within the SLE cohort. Results: In comparison to healthy controls, SLE patients presented with significantly higher CAVI, GLS, and hsTnI levels, while VAC was significantly reduced (p < 0.001). Furthermore, SLE patients with active disease (SELENA–SLEDAI ≥ 4) exhibited higher levels of CAVI and troponin than those with inactive disease (p < 0.001). SLEDAI was an independent predictor of CAVI, while VAC and SLEDAI were independent determinants of hsTnI in the SLE cohort. Conclusions: SLE patients displayed abnormal levels of CAVI, VAC, GLS, and troponin compared to healthy individuals. Our findings implicate the potential of those CV novel CVD risk factors to refine screening and therapeutic strategies for this specific population. Full article

(This article belongs to the Special Issue Novel Echocardiographic Techniques for the Assessment of Cardiovascular Disease)

13 pages, 320 KiB

Open AccessArticle

Effects of Liraglutide, Empagliflozin and Their Combination on Left Atrial Strain and Arterial Function

by Konstantinos Katogiannis, John Thymis, Foteini Kousathana, George Pavlidis, Emmanouil Korakas, Aikaterini Kountouri, Konstantinos Balampanis, Vasiliki Prentza, Gavriella Kostelli, Helen Michalopoulou, Damianos Tsilivarakis, Vaia Lambadiari and Ignatios Ikonomidis

Medicina 2024, 60(3), 395; https://doi.org/10.3390/medicina60030395 - 26 Feb 2024

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Abstract

Background and Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are cardioprotective drugs. We investigated their effects on left atrial function, a major determinant of cardiac diastolic dysfunction in type 2 diabetes mellitus. We also explored the association of changes in arterial stiffness with those of the LA strain after treatment. Materials and Methods: A total of 200 patients (59.5 ± 9.1 year old, 151 male) with type 2 diabetes mellitus treated with metformin were randomized to insulin (n = 50 served as controls), liraglutide (n = 50), empagliflozin (n = 50) or their combination (liraglutide + empagliflozin) (n = 50). We measured at baseline and 6 months post-treatment: (a) left atrial and global left ventricular longitudinal strain by speckle tracking echocardiography; (b) pulse wave velocity (PWV) and central systolic blood pressure. Results: At baseline, there was a correlation of the LA reservoir strain with PWV (r = −0.209, p = 0.008), central SBP (r = −0.151, p = 0.030), EF (r = 0.214, p = 0.004) and GLS (r = −0.279, p = 0.009). The LA reservoir change 6 months post-treatment was correlated with the PWV change in all groups (r = −0.242, p = 0.028). The LA reservoir change 6 months post-treatment was correlated with the GLS change in all groups (r = −0.322, p = 0.004). Six months after intervention, patients treated with liraglutide, empagliflozin and their combination improved the left atrial reservoir strain (GLP1RA 30.7 ± 9.3 vs. 33.9 ± 9.7%, p = 0.011, SGLT2i 30 ± 8.3 vs. 32.3 ± 7.3%, p = 0.04, GLP1&SGLT2i 29.1 ± 8.7 vs. 31.3 ± 8.2, p = 0.007) compared to those treated with insulin (33 ± 8.3% vs. 32.8 ± 7.4, p = 0.829). Also, patients treated with liraglutide and the combination liraglutide and empagliflozin had improved left atrial conduction strain (p < 0.05). Empagliflozin or the combination liraglutide and empagliflozin showed a greater decrease of PWV and central and brachial systolic blood pressure than insulin or GLP-1RA. (p < 0.05). Conclusions: Impaired aortic elastic properties are associated with a decreased LA strain in type 2 diabetics. Treatment with liraglutide, empagliflozin and their combination for 6 months showed a greater improvement of left atrial function compared to insulin treatment in parallel with the improvement of arterial and myocardial functions. Full article

(This article belongs to the Special Issue Novel Echocardiographic Techniques for the Assessment of Cardiovascular Disease)

10 pages, 1190 KiB

Open AccessArticle

Effects of an Impaired Fasting Glucose on the Left Atrial Strain Evaluated by Speckle Tracking Echocardiography

by Gülsüm Bingöl, Fulya Avcı Demir, Emre Özmen, Serkan Ünlü, Özge Özden, Kardelen Ohtaroğlu Tokdil, Leyla Bulut Arsoy, Fatma Özpamuk Karadeniz and Barış Ökçün

Medicina 2023, 59(11), 1982; https://doi.org/10.3390/medicina59111982 - 10 Nov 2023

Viewed by 839

Abstract

Background and Objectives: Similar to diabetes, the presence of left ventricular (LV) diastolic function (DD) has been reported in various studies which were conducted with people with a diagnosis of an impaired fasting blood glucose (FBG). This study aimed to examine the effects of the fasting blood glucose (FBG) levels on the left atrial strain (LAS) estimated by two-dimensional echocardiography speckle tracking analyses in patients without known diabetes. Material and Methods: The study included 148 participants (74 female and 74 male) without a history of diabetes mellitus or chronic disease. The patients were divided into two groups as follows: individuals with an FBG < 100 mg/dL and those with an FBG between 100 and 125 mg/dL after at least 8 h of overnight fasting. According to these FBG levels, speckle tracking echocardiography (STE) measures were compared. Results: There was a significant decrease in the LA reservoir (52.3 ± 15 vs. 44.5 ± 10.7; p = 0.001) and conduit strain (36.9 ± 11.7 vs. 28.4 ± 9.7; p = 0.001) in the impaired FBG group. When the STE findings of both ventricles were compared, no significant difference was observed between the groups in right and left ventricular strain imaging. Conclusions: In the earliest stage of LVDD, changes in atrial functional parameters become particularly evident. Echocardiographic analyses of these parameters can help to diagnose and determine the degree of LVDD while the morphological parameters are still normal. The addition of LAS imaging to routine transthoracic echocardiography (TTE) studies in patients with an impaired FBG but without a DM diagnosis may be helpful in demonstrating subclinical LVDD or identifying patients at risk for LVDD in this patient group. Full article

(This article belongs to the Special Issue Novel Echocardiographic Techniques for the Assessment of Cardiovascular Disease)

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Review

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20 pages, 2381 KiB

Open AccessReview

The Clinical Applications of Left Atrial Strain: A Comprehensive Review

by Thomas O’Neill, Puneet Kang, Andreas Hagendorff and Bhupendar Tayal

Medicina 2024, 60(5), 693; https://doi.org/10.3390/medicina60050693 - 24 Apr 2024

Viewed by 719

Abstract

Left atrial (LA) strain imaging, which measures the deformation of the LA using speckle-tracing echocardiography (STE), has emerged recently as an exciting tool to help provide diagnostic and prognostic information for patients with a broad range of cardiovascular (CV) pathologies. Perhaps due to the LA’s relatively thin-walled architecture compared with the more muscular structure of the left ventricle (LV), functional changes in the left atrium often precede changes in the LV, making LA strain (LAS) an earlier marker for underlying pathology than many conventional echocardiographic parameters. LAS imaging is typically divided into three phases according to the stage of the cardiac cycle: reservoir strain, which is characterized by LA filling during systole; conduit strain, which describes LA deformation during passive LV filling; and booster strain, which provides information on the LA atrium during LA systole in late ventricular diastole. While additional large-population studies are still needed to further solidify the role of LAS in routine clinical practice, this review will discuss the current evidence of its use in different pathologies and explore the possibilities of its applications in the future. Full article

(This article belongs to the Special Issue Novel Echocardiographic Techniques for the Assessment of Cardiovascular Disease)

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